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Aug 2012

Expanding the Envelope of Care

Author Affiliations

Author Affiliations: Department of Medical Ethics and Pediatric Advanced Care Team (Dr Feudtner) and Division of Cardiology (Dr Mott), The Children's Hospital of Philadelphia, and Department of Pediatrics, The Perelman School of Medicine, University of Pennsylvania (Drs Feudtner and Mott), Philadelphia.

Arch Pediatr Adolesc Med. 2012;166(8):772-773. doi:10.1001/archpediatrics.2012.150

Pediatric cardiac surgery and cardiology care have been transformed during the past 3 decades by tremendous innovation and steady improvements. Relentlessly, the pediatric cardiac care community has pushed the envelope of what can be done to previously unimagined limits, and this is to be celebrated. Yet, with expanding capabilities come increasingly demanding choices. The key question is how to enlarge the envelope of care so that children (and their families) receive technically outstanding care in the context of ongoing decision support so that we provide all that should be done for the patient without crossing a line—admittedly, and yet also essentially, a line based on judgment—and lapsing into doing merely what, technically, can be done to the patient.

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