This post appears by special arrangement with the American Journal of Bioethics.
by John D. Lantos, MD
In this issue, Macklin and Natanson examine some of the controversies that arise in randomized clinical trials (RCTs). They are particularly concerned that researchers may misrepresent novel interventions as “usual care.” This is problematic, they claim, both ethically and scientifically. Ethically, it misleads potential research participants into believing that studies have known and minimal risks. Scientifically, such studies may lead to erroneous conclusions about the relative efficacy of specific practices.
Implicit in their critique are two ideas. The first is that we can know what “usual care” is.…
by John Lantos, MD
Dr. William L. Meadow, MD, PhD, died at the age of 70 on Saturday, September 14, after battling leukemia for four years. Meadow was a pioneer in the development of neonatal bioethics. We worked closely on a series of articles and a book about the complex set of medical and personal calculations that guide decision making for the parents, physicians and nurses who care for critically ill infants. The tough decisions generally occur when infants are born at the borderline of viability or those with significant congenital problems or infections.
by John D. Lantos, Ph.D
The impassioned and well-reasoned essays in this edition of the journal all agree with two claims: (1) children have moral claims that should be protected and recognized, and (2) we need ongoing discussions on how to determine and weigh the interests of children when we make decisions for them. They disagree about how we should determine and weigh those interests. The disagreements suggest that we clearly have not found an all-encompassing principle or theory that will resolve all cases. That is less of a problem than these essays suggest.…