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John lantos

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https://www.readbyqxmd.com/read/29114060/ethics-rounds-death-after-pediatric-dental-anesthesia-an-avoidable-tragedy
#1
Helen Lee, Peter Milgrom, Colleen E Huebner, Philip Weinstein, Wylie Burke, Erika Blacksher, John D Lantos
Early childhood caries (ECC) is the single most common chronic childhood disease. In the treatment of ECC, children are often given moderate sedation or general anesthesia. An estimated 100 000 to 250 000 pediatric dental sedations are performed annually in the United States. The most common medications are benzodiazepines, opioids, local anesthetics, and nitrous oxide. All are associated with serious adverse events, including hypoxemia, respiratory depression, airway obstruction, and death. There is no mandated reporting of adverse events or deaths, so we don't know how often these occur...
November 7, 2017: Pediatrics
https://www.readbyqxmd.com/read/29111925/to-whom-do-children-belong
#2
John Lantos
No abstract text is available yet for this article.
November 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/29109104/advocating-for-the-dream-act-why-pediatricians-should-care-and-what-they-can-do
#3
Mark Kuczewski, John D Lantos, Zarna Patel
No abstract text is available yet for this article.
November 6, 2017: Pediatrics
https://www.readbyqxmd.com/read/29101225/weighing-the-social-and-ethical-considerations-of-maternal-fetal-surgery
#4
Ryan M Antiel, Alan W Flake, Christopher A Collura, Mark P Johnson, Natalie E Rintoul, John D Lantos, Farr A Curlin, Jon C Tilburt, Stephen D Brown, Chris Feudtner
OBJECTIVES: The ethics of maternal-fetal surgery involves weighing the importance of potential benefits, risks, and other consequences involving the pregnant woman, fetus, and other family members. We assessed clinicians' ratings of the importance of 9 considerations relevant to maternal-fetal surgery. METHODS: This study was a discrete choice experiment contained within a 2015 national mail-based survey of 1200 neonatologists, pediatric surgeons, and maternal-fetal medicine physicians, with latent class analysis subsequently used to identify groups of physicians with similar ratings...
November 3, 2017: Pediatrics
https://www.readbyqxmd.com/read/29097071/neonatal-research-ethics-after-support
#5
REVIEW
John D Lantos
The SUPPORT study (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments), sponsored by the Eunice Kennedy Shriver National Institute of Child Health and Human Development to evaluate different oxygen saturation targets for extremely premature babies, led to a national controversy that was surprisingly public, intense, and polarizing. This article describes the study design, the study outcomes, and the key issues. I conclude that the controversy was based on two different views of the clinical investigator...
October 30, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29051330/cross-cultural-differences-in-communication-about-a-dying-child
#6
Donald Cochran, Sarosh Saleem, Sumaira Khowaja-Punjwani, John D Lantos
There are more migrants, refugees, and immigrants adrift in the world today than at any time in the recent past. Doctors and hospitals must care for people from many different cultures, countries, and religious backgrounds. We sometimes find our own deeply held beliefs and values challenged. In this "Ethics Rounds," we present a case in which a Pakistani immigrant family faces a tragic medical situation and wants to deal with it in ways that might be normative in their own culture but are aberrant in ours. We asked the American doctors and 2 Pakistani health professionals to think through the issues...
November 2017: Pediatrics
https://www.readbyqxmd.com/read/29018178/attitudes-of-paediatric-and-obstetric-specialists-towards-prenatal-surgery-for-lethal-and-non-lethal-conditions
#7
Ryan M Antiel, Farr A Curlin, John D Lantos, Christopher A Collura, Alan W Flake, Mark P Johnson, Natalie E Rintoul, Stephen D Brown, Chris Feudtner
BACKGROUND: While prenatal surgery historically was performed exclusively for lethal conditions, today intrauterine surgery is also performed to decrease postnatal disabilities for non-lethal conditions. We sought to describe physicians' attitudes about prenatal surgery for lethal and non-lethal conditions and to elucidate characteristics associated with these attitudes. METHODS: Survey of 1200 paediatric surgeons, neonatologists and maternal-fetal medicine specialists (MFMs)...
October 10, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28975473/why-are-there-so-few-ethics-consults-in-children-s-hospitals
#8
Brian Carter, Manuel Brockman, Jeremy Garrett, Angie Knackstedt, John Lantos
In most children's hospitals, there are very few ethics consultations, even though there are many ethically complex cases. We hypothesize that the reason for this may be that hospitals develop different mechanisms to address ethical issues and that many of these mechanisms are closer in spirit to the goals of the pioneers of clinical ethics than is the mechanism of a formal ethics consultation. To show how this is true, we first review the history of collaboration between philosophers and physicians about clinical dilemmas...
October 3, 2017: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/28924060/the-dilemma-of-predicting-violent-radicalization
#9
Cécile Rousseau, B Heidi Ellis, John D Lantos
Parents, educators, law enforcement officials, and health professionals are all concerned about the violent radicalization of adolescents. Health professionals may be called on to assess teenagers regarding the risk that they will become dangerous. We present a case in which a psychiatrist is asked to do a forensic evaluation of a young adolescent who said troubling things and had some concerning posts on his Facebook page. The evaluation reveals things about both the young boy and his community.
October 2017: Pediatrics
https://www.readbyqxmd.com/read/28818435/a-parent-reveals-the-biases-that-she-faced-to-get-care-for-her-daughter
#10
Sosha Chaney, John D Lantos
A poor, African-American mother describes the difficulties that she has in getting a comprehensive medical evaluation for her child in an Emergency Room. Eventually, she finds the care and the caring that she needs at a medical clinic in a community health center.
August 14, 2017: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/28814577/physician-nurse-interactions-in-critical-care
#11
Sumaira Khowaja-Punjwani, Charlotte Smardo, Monica Rita Hendricks, John D Lantos
Nearly 20% of nurses leave their first job within a year of being hired. Many do so because they perceive the work environment to be unhealthy or nonsupportive. Nurse turnover is costly. When new nurses leave within 3 years of being hired, it costs the hospital $64 000, over and above salaries, to replace them. One of the hallmarks of an unhealthy work environment is poor communication between doctors and nurses. We present a case in which a nurse advocates for a young mother by questioning the doctor. She is reprimanded for doing so...
September 2017: Pediatrics
https://www.readbyqxmd.com/read/28807641/a-novel-partnership-disrupts-the-norm-in-early-childhood-education-and-pediatric-health-care
#12
EDITORIAL
M Denise Dowd, John D Lantos
Children living in poverty in the United States in 2016 face a devastating combination of psychological problems. Their neighborhoods are often violent. They have no place to get healthy food. It is not safe to play outside, even on playgrounds. The children who grow up in this environment, not surprisingly, have many adverse childhood experiences (ACEs). ACEs cause toxic stress. Toxic stress leads to long-term physical and psychological problems. For many pediatricians, children's hospitals, civic leaders, and public health officials, it is difficult to know how to intervene...
August 11, 2017: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/28800375/the-tragic-case-of-charlie-gard
#13
John D Lantos
No abstract text is available yet for this article.
October 1, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28768131/what-we-do-when-we-resuscitate-extremely-preterm-infants
#14
Jeremy R Garrett, Brian S Carter, John D Lantos
No abstract text is available yet for this article.
August 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/28759411/controversy-about-dialysis-for-an-adolescent
#15
Tyler Tate, Aviva Goldberg, Aaron Wightman, Bradley A Warady, John D Lantos
For patients on dialysis, 1 frequent cause of death is their voluntary decision to discontinue dialysis. Such decisions raise complex questions when the patient is a competent adult. The decisions are even more complex when the patient is an adolescent. In this article, we present a case in which a 17-year-old adolescent decided that she no longer wished to undergo dialysis through her fistula. Her doctors thought that dialysis using any other technique would be too dangerous. Four experts in pediatric nephrology, bioethics, and palliative care discuss this decision and the different ways that the health care team might respond...
July 2017: Pediatrics
https://www.readbyqxmd.com/read/28679640/palliative-sedation-with-propofol-for-an-adolescent-with-a-dnr-order
#16
Liza-Marie Johnson, Joel Frader, Joanne Wolfe, Justin N Baker, Doralina L Anghelescu, John D Lantos
Death from cancer is often painful. Usually, the pain can be relieved in ways that allow patients to remain awake and alert until the end. Sometimes, however, the only way to relieve pain is to sedate patients until they are unconscious. This method has been called palliative sedation therapy. Palliative sedation therapy is controversial because it can be misunderstood as euthanasia. We present a case in which an adolescent who is dying of leukemia has intractable pain. Experts in oncology, ethics, pain management, and palliative care discuss the trade-offs associated with different treatment strategies...
August 2017: Pediatrics
https://www.readbyqxmd.com/read/28667766/shared-decision-making-value-pluralism-and-the-zone-of-parental-discretion
#17
Joseph W Kaempf, Nicholas Kockler, Mark W Tomlinson
"Good ethics start with good facts" wrote John Lantos and William Meadow in a 2009 editorial addressing periviability controversies - debates that continue to generate lively discussion amongst neonatologists, obstetricians, ethicists, and families (1). How do we best promote shared decision making with pregnant women who, through no fault of their own, might deliver an extremely premature infant? Unfortunately, the recent "A Different View" in this journal by Dr. Patrick Marmion regarding periviability issues in general, and specifically our shared decision making model at Providence St...
July 1, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28562274/ethical-controversy-about-hysterectomy-for-a-minor
#18
Alyssa M Burgart, Julie Strickland, Dena Davis, Arlene B Baratz, Katrina Karkazis, John D Lantos
One of the most complicated ethical issues that arises in children's hospitals today is the issue of whether it is ever permissible to perform a procedure for a minor that will result in permanent sterilization. In most cases, the answer is no. The availability of good, safe, long-acting contraception allows surgical options to be postponed when the primary goal of such surgical options is to prevent pregnancy. But what if a minor has congenital urogenital anomalies or other medical conditions for which the best treatment is a hysterectomy? In those cases, the primary goal of therapy is not to prevent pregnancy...
June 2017: Pediatrics
https://www.readbyqxmd.com/read/28557751/grief-and-burnout-in-the-picu
#19
Suzanne Crowe, Shayla Sullivant, Laura Miller-Smith, John D Lantos
Doctors and nurses who work in PICUs often deal with emotionally difficult events. These events take a toll. They can cause long-term psychological problems that, if not addressed, can impair the ability of doctors and nurses to care for patients in a competent and compassionate manner. Furthermore, effective treatment is available. But there is a paradox. To get treatment, one must acknowledge the problem. Acknowledgment of the problem may not be encouraged, or may be discouraged and stigmatized, in the intensive care culture...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28509687/trust-in-the-medical-profession-among-adolescents-in-an-emergency-department
#20
Kelstan Lynch Ellis, Kimberly Randell, John Lantos, Melissa K Miller
OBJECTIVE: The aims of this study were to assess trust in the medical profession among adolescents in an urban pediatric emergency department (ED) and explore factors associated with trust. METHODS: We used a computerized survey to assess personal trust, perceived trust among family/friends, health care use, general and genital examination preferences, health behaviors, and demographics among youth aged 14 to 19 years. The primary outcome was the mean composite score of a validated 5-item scale...
May 15, 2017: Pediatric Emergency Care
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