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Invited Critique
September 01, 2008

Ethics in the Midst of Therapeutic Evolution

Arch Pediatr Adolesc Med. 2008;162(9):854-857. doi:10.1001/archpedi.162.9.854

What ethical challenges arise when, in an era like ours, the frequent arrival of new therapeutic interventions constantly transforms the status quo of health care, pushing forward the boundary of what is possible and, perhaps, desirable? Several of these challenges come into particular focus in 2 articles in this issue of Archives. Both articles scrutinize the treatment options offered to parents of infants with hypoplastic left heart syndrome (HLHS), and both reach resolute but differing opinions regarding whether palliative care should be routinely offered.While this debate involves data that are very specific to HLHS, data that have changed over time and likely vary across treatment centers, close examination of the arguments reveals more general issues about how complex clinical treatment decisions are—and should be—made.

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