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On My Mind
Aug 2012

The Darkening Veil of “Do Everything”

Author Affiliations

Author Affiliations: Departments of Anesthesiology and Critical Care and Medical Ethics, Pediatric Advanced Care Team, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Arch Pediatr Adolesc Med. 2012;166(8):694-695. doi:10.1001/archpediatrics.2012.175

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.

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