Author Affiliations: Departments of Anesthesiology and Critical Care and Medical Ethics, Pediatric Advanced Care Team, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
The hour is late and the situation dire. Huddled by the patient's bedside, a nurse and respiratory therapist stand just behind the physician who speaks to the family members. Sometimes the patient is a child—perhaps an infant, just born, with severe congenital anomalies, or maybe a toddler who fell into a pool and nearly drowned. Other times, the patient is far older, and may have had a sudden massive heart attack or may have been living with progressive cancer for months or years. The family members could be young parents or a spouse married half a century. The conversation focuses on the patient's history and diagnosis, the gravity of the predicament, and the possible treatment options, outlining the possible benefits and harms.
Feudtner C, Morrison W. The Darkening Veil of “Do Everything”. Arch Pediatr Adolesc Med. 2012;166(8):694-695. doi:10.1001/archpediatrics.2012.175