ABSTRACT
In caring for the extremely premature neonate with surgical disease or the infant with multiple, life-threatening congenital anomalies, pediatric surgeons often encounter difficult ethical decisions about the use of advanced, life-sustaining treatments and operative interventions. The imperative to utilize new technology is tempered with concerns about quality of life, informed parental decision making, and access to scarce medical resources. Pediatric surgeons, families and communities ask the difficult ethical question: ‘We can do this particular intervention, but, should we?’ This chapter provides the pediatric surgeon with ethical guidelines to utilize in clinical situations in which therapeutic decisions contain uncertainty or conflict and the next steps in the management of an infant that poses challenges for the parents and physicians.
