TY - JOUR
T1 - Ethical considerations for cardiac surgical interventions in children with trisomy 13 and trisomy 18
AU - Neubauer, Kathryn
AU - Boss, Renee D.
N1 - Publisher Copyright:
© 2020 Wiley Periodicals, Inc.
PY - 2020/3/1
Y1 - 2020/3/1
N2 - Medical and surgical approaches to children with trisomy 13 and 18 are evolving, and an increasing number of patients are being considered for simple and complex cardiac procedures. This review describes how the shifts in medical and social considerations for children with trisomy 13 and 18 mirror the shifts that occurred 50 years ago for children with trisomy 21. Yet the variability in cardiac lesions, and variability in non-cardiac comorbidities, is much greater for patients with trisomy 13 and 18 than for those with trisomy 21. That variability, combined with the severe neurologic impairment in survivors, complicates the current risk: benefit balance of surgical intervention. Consistent approaches to care for these patients should be built on an evidence base, and should include contributions from specialists in medical ethics and palliative care.
AB - Medical and surgical approaches to children with trisomy 13 and 18 are evolving, and an increasing number of patients are being considered for simple and complex cardiac procedures. This review describes how the shifts in medical and social considerations for children with trisomy 13 and 18 mirror the shifts that occurred 50 years ago for children with trisomy 21. Yet the variability in cardiac lesions, and variability in non-cardiac comorbidities, is much greater for patients with trisomy 13 and 18 than for those with trisomy 21. That variability, combined with the severe neurologic impairment in survivors, complicates the current risk: benefit balance of surgical intervention. Consistent approaches to care for these patients should be built on an evidence base, and should include contributions from specialists in medical ethics and palliative care.
UR - http://www.scopus.com/inward/record.url?scp=85078717064&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85078717064&partnerID=8YFLogxK
U2 - 10.1002/ajmg.c.31767
DO - 10.1002/ajmg.c.31767
M3 - Comment/debate
C2 - 31975573
AN - SCOPUS:85078717064
SN - 1552-4868
VL - 184
SP - 187
EP - 191
JO - American Journal of Medical Genetics, Part C: Seminars in Medical Genetics
JF - American Journal of Medical Genetics, Part C: Seminars in Medical Genetics
IS - 1
ER -