Alfie Evans and Our Moral Crossroads | First Things
Physicians have many ways of influencing medical decisions made by the parents of children in their care.Certain studies can be cited in support of what the physician desires, and studies pointing in a different direction can be ignored. Directive, emotive, and exaggerated language can be used to manipulate, especially when the likely outcomes of various options are under discussion. Numbers can be used in a similar way: Should a consult focus on the two-thirds of patients who have poor outcomes—or on the one-third who have good ones?These forms of manipulation are a persistent concern in clinical ethics, and they present themselves in dramatic fashion when medical teams discuss disability.Sometimes the desire of a physician to achieve the outcome he wants is so strong that he will engage in deceptive practices called “slow coding” or “show coding.” The physician agrees with the parents that everything possible will be done for their child (“full code”)—but in reality the physician and medical team will not engage in aggressive treatment. This practice is defended by some ethicists today, and is often justified by the physician’s personal judgment that the life of a particular child is not worth saving.
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