The Lazarus Case: Life-and-Death Issues in Neonatal Intensive Care (Medicine and Culture) - Hardcover

Lantos MD, John D.

Hardcover

ISBN 10: 0801867622 ISBN 13: 9780801867620

Publisher: Johns Hopkins University Press, 2001

Synopsis

A gripping exploration of the legal and ethical dilemmas in neonatal intensive care―a truly original work.

Chosen as an Outstanding Academic Titles in 2003 by Choice Magazine

In this new, startlingly original book, John D. Lantos weaves a compelling story that captures the dilemmas of modern medical practice. The Lazarus Case: Life-and-Death Issues in Neonatal Intensive Care begins with a fictional malpractice case―an amalgam of typical cases in which Lantos appeared as an expert witness―and uses it as the framework for addressing the ethical issues surrounding neonatal intensive care. Lantos draws on his experience in neonatal medicine, pediatrics, and medical ethics to explore multiple ethical dilemmas through one poignant representative situation.

In Lantos's model case, a doctor decides to stop resuscitation of a premature infant, a tiny "preemie" who seems past reasonable care. The baby survives with severe neurological defects and the parents sue the doctor, alleging that stopping treatment was negligent. From this case, Lantos considers our moral obligations to critically ill babies, the meaning of negligence, and the sorts of social structures that shape the moral consciences of doctors.

Each chapter begins with Lantos deposing in the conference room of the plaintiffs' lawyers. The questions put to Lantos throughout the deposition spark an engrossing retelling of his personal experiences with premature babies, as well as his thoughtful discussions of ethics, morality, history, and medical statistics. Sprinkled throughout the book are references to fictional works by Camus, Dostoevsky, Shakespeare, Twain, and others. Lantos uses these literary examples to further illustrate the ambiguities, misunderstandings, responsibilities, and evasions that plague our decisions regarding life and death, medical care and medical education, and ultimately the cost and value of preserving the lives of the most vulnerable among us.

About this title

About the Author

John D. Lantos, M.D., is a professor of pediatrics at the University of Chicago and holds the John B. Francis Chair in Bioethics at the Center for Practical Bioethics in Kansas City. He is the author of The Lazarus Case: Life-and-Death Issues in Neonatal Intensive Care (Johns Hopkins University Press, 2001).

From the Back Cover

Outstanding Academic Title, 2003, Choice Magazine

In this startlingly original book, John D. Lantos weaves a compelling story that captures the dilemmas of modern medical practice. The Lazarus Case begins with a fictional malpractice case―an amalgam of typical cases in which Lantos has testified as an expert witness―and uses it as the framework for addressing the ethical issues surrounding neonatal intensive care. Lantos draws on his experience in neonatal medicine, pediatrics, and medical ethics to explore multiple ethical dilemmas through one poignant representative situation.

From the Inside Flap

Outstanding Academic Title, 2003, Choice Magazine

In this startlingly original book, John D. Lantos weaves a compelling story that captures the dilemmas of modern medical practice. The Lazarus Case begins with a fictional malpractice case--an amalgam of typical cases in which Lantos has testified as an expert witness--and uses it as the framework for addressing the ethical issues surrounding neonatal intensive care. Lantos draws on his experience in neonatal medicine, pediatrics, and medical ethics to explore multiple ethical dilemmas through one poignant representative situation.

--Felicia G. Cohn "Religious Studies Review"

Reviews

Neonatal intensive care is one of the most dramatic recent advances in medicine. Every year, 53,000 babies are born prematurely in the United States. The newborn intensive care unit, with its sophisticated technology, has become the artificial womb for these infants, and although most infants treated in this unit go on to lead full and productive lives, others are left with multiple problems, such as blindness, seizures, chronic lung disease, and neurologic damage. This is one reason the health care system in the United States is sometimes seen as mindlessly driven by a technological imperative. In The Lazarus Case, John Lantos, a pediatrician and ethicist at the University of Chicago, critically examines the moral predicaments physicians face in making choices for these vulnerable infants. As an illustration, Lantos presents a malpractice case, one that is really an amalgam of cases in which he has testified as an expert in medical ethics. The case is that of a premature infant who is born at 25 weeks' gestation and weighs 650 g and for whom cardiopulmonary resuscitation is performed at birth. After 10 minutes of resuscitative efforts, the neonatologist decides to stop. Unexpectedly, however, the infant survives but has severe neurologic damage. The neonatologist is sued for having provided inadequate resuscitative efforts. Lantos highlights the moral choices faced by the parents and the health care team. In describing their agony over the morality of suffering that is associated with neonatal intensive care and the uncertainty of outcomes there, the author very nicely draws on the work of distinguished authors such as Feodor Dostoyevsky, Kenzaburo Oe, Lewis Thomas, and Mark Twain. He says, "Doctors who pursue survival at any cost can be seen as morally pure or morally simplistic or profoundly irresponsible and insensitive to the needs of real human communities." As Lantos "wrestles" with the plaintiff's attorney, he brings out the disparity between moral theory and professional practice. Lantos has taken an important practical problem and applied our understanding of moral and ethical theory to the issue of the appropriateness of care. An important message here is that in the context of this particular case, there are no right or wrong answers to the questions posed. This book will be of interest to the general public and to health care workers. At times, technical details are injected into the narrative that would be difficult for nonmedical readers to understand. The style of writing would have benefited from editorial assistance. However, these are minor reservations about a book that has admirably succeeded in its purpose -- to convey the essence of moral dilemmas faced each day by those who care for these vulnerable, extremely premature infants. I. David Todres, M.D.
Copyright © 2002 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

Lantos (Do We Still Need Doctors?) here draws on his personal experiences as a pediatrician and medical ethics expert at the University of Chicago to consider the complexities involved in neonatal intensive care. Using an idealized malpractice case to illustrate his points, he discusses the history, culture, and economics of neonatal care, considering when treatment should be given and withheld, who determines how aggressively life-support treatment should be pursued, and who should participate in treatment decisions. Lantos skillfully shows how difficult it is to determine standards of care for these tiny babies. Many books have been published about the ethical dilemmas surrounding premature births, but this title, written in a style that should appeal to general readers, stands out as a solid introduction to these issues. Recommended for public and academic libraries. Tina Neville, Univ. of South Florida Lib. at St. Petersburg
Copyright 2001 Reed Business Information, Inc.

Edition details

• Publisher: Johns Hopkins University Press
• Publication date: 2001
• Language: English
• ISBN 10: 0801867622
• ISBN 13: 9780801867620
• Binding: Hardcover
• Edition number: 1
• Number of pages: 208