Death or Disability? the Carmentis Machine and Decision-Making for Critically Ill Children

Description

• Written by an expert in both paediatrics and ethics
• Illuminates the medical and scientific aspects of ethical dilemmas
• Draws on the latest in neuroscience
• Moves the debate forwards, with practical suggestions

In ancient Rome parents would consult the priestess Carmentis shortly after birth to obtain prophecies of the future of their newborn infant. Today, parents and doctors of critically ill children consult a different oracle. Neuroimaging provides a vision of the child's future, particularly of the nature and severity of any disability. Based on the results of brain scans and other tests doctors and parents face heart-breaking decisions about whether or not to continue intensive treatment or to allow the child to die. 

Paediatrician and ethicist Dominic Wilkinson looks at the profound and contentious ethical issues facing those who work in intensive care caring for critically ill children and infants. When should infants or children be allowed to die? How accurate are predictions of future quality of life? How much say should parents have in these decisions? How should they deal with uncertainty about the future? He combines philosophy, medicine and science to shed light on current and future dilemmas.

Table of Contents

Prologue 1: The temple of Carmentis 30AD
Prologue 2: The Carmentis Machine: 2030 AD
Introduction: Neuroethics and intensive care
Section A
1: Destiny, disability, and death
2: Best interests and the Carmentis machine
3: Starting again
4: Competing interests
Section B
5: Sources of Uncertainty—prognostic research
6: Managing uncertainty
7: Interests and uncertainty
8: The Threshold framework
Index

Author Information

Dominic Wilkinson, University of Adelaide

Dominic Wilkinson is Professor of Medical Ethics at the Oxford Uehiro Centre for Practical Ethics, University of Oxford, research fellow at Jesus College, and a consultant neonatologist at the John Radcliffe Hospital, Oxford.