What is left of futility? The convergence of anencephaly and the Emergency Medical Treatment and Active Labor Act

Article Abstract:

A law intended to keep hospitals from refusing indigent patients emergency care may be force hospitals to administer treatment to patients when treatment is futile. The law says hospitals must examine any patient who requests treatment and must either stabilize emergency conditions or transfer the patient appropriately to another hospital. Citing this law, the courts ruled that an anencephalic child who was born with only a brain stem must be given emergency care despite her poor prognosis. The concept of futility has two interpretations. Doctors and hospitals are under no obligation to treat patients if the treatment would be futile because it would not work, as for example, resuscitating a person who had no heartbeat for an hour. But, because terminally ill patients may want emergency care, the court deemed that the law requires medical treatment if the patient or patient's guardian requests it regardless of the patient's long-term prognosis.

Care and treatment, Cases, Refusal to treat (Medicine), Anencephaly

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An ethics curriculum for the pediatric residency program: confronting barriers to implementation

Article Abstract:

Physicians from the pediatric residency program at Children's Hospital and Medical Center in Seattle, WA, describe how they implemented an ethics curriculum in the training of pediatricians. The American Board of Pediatrics required structured ethics training in residency programs in Feb 1997. Children's Hospital integrated ethics training into existing resident conferences, focusing on discussion of individual cases that present ethical dilemmas. This arrangement facilitated effective ethics training despite varying schedules and participation by pediatric residents.

Standards, Study and teaching, Medical ethics, American Board of Pediatrics

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Documenting the educational content of morning report

Article Abstract:

The pediatric morning report represents an important educational opportunity for pediatric residents. During morning report, several patient cases are discussed, especially those that present a diagnostic challenge. A review of all pediatric morning reports at one hospital over a 12-month period revealed that the diagnoses discussed covered 72% of the educational objectives proposed by the American Academy of Pediatrics for the training of pediatric residents. Morning report can provide residents with skills that they could not easily learn otherwise.

Curricula, Graduate medical education, Postgraduate medical education

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