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May 13, 2019

Estimating Neurologic Prognosis in Children: High Stakes, Poor Data

Author Affiliations
  • 1School of Medicine, Duke University, Durham, North Carolina
  • 2Duke-Margolis Center for Health Policy, Duke University, Durham, North Carolina
  • 3Fuqua School of Business, Duke University, Durham, North Carolina
  • 4Department of Pediatrics and Clinical Ethics, University of Montreal, Montreal, Quebec, Canada
  • 5Neonatology, Clinical Ethics, Palliative Care, Sainte-Justine Hospital, Montreal, Quebec, Canada
JAMA Neurol. 2019;76(8):879-880. doi:10.1001/jamaneurol.2019.1157

Parents of critically ill children often ask their physicians to predict their child's future so that they can make medical decisions and plan for his or her life. The stakes can be high: some parents must decide whether to resuscitate a child if he or she deteriorates, whether to remove the ventilator in the face of brain injury, or how to balance the possibilities of death and life with future disability. Other families face less acute decisions, such as whether to relocate to a home with disability access or transition to a different type of school. The child’s prognosis—what life might look like in the future—is central to these choices.