Jecker_Cases_Enhancement Lecture Slides

The boys risks of falling and hitting his head were

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serious risks with questionable benefits. The boy’s risks of falling and hitting his head were nearly zero since he remained in bed unless placed in a wheelchair. * Case adapted from Opel and Wilfond, “Cosmetic surgery in children with cognitive disabilities” Hastings Center Report 39, 2009: 19-21. Contd. Four Box Analysis Medical Indications Patient Preferences Quality of Life Contextual Features Case 2 Jani is 1 year old born with Trisomy 18. Children with this syndrome have profound cognitive disabilities, kidney & heart problems, and physical deformities. Half of infants with T18 do not survive beyond the 1st week of life. Some have survived to the teenage years, but with serious medical and developmental problems. Jani was also born with cleft lip palate, and is in the hospital for cleft lip surgery. Although Jani’s cognitive disabilities would prevent her from being aware of any psychosocial benefits that cleft lip surgery may promise, her parents are requesting the procedure. Case 2 The surgeon who would perform the procedure, Dr. Nguyen, asks for an ethics consult. She is concerned that the only beneficiary of this procedure will be the parents, not the pt. * Case adapted from Opel and Wilfond, “Cosmetic surgery in children with cognitive disabilities” Hastings Center Report 39, 2009: 19-21.
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