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Readers Join Debate on Medical Ethics

August 26, 1991

Pamela Warrick's series on pediatric medical ethics (Aug. 4 and 5) provides a great service to The Times' readers. She clearly reports the tremendous human and financial costs of making life-and-death decisions for critically ill children and extremely premature newborns.

Many of her questions are truly difficult. However, the answer to one is clear. She asks: "Should doctors and nurses employ all their medical powers to keep a baby alive to spare a family who can't give up hope?"

This is not open to debate. The answer is "no." They should employ their medical powers to keep a baby alive to benefit the baby, not to benefit the family. While it may seem harsh to force a family to confront the inevitability of a child's death, it is ultimately more cruel to both the child and the family for the child to suffer a needlessly protracted death. Such child cruelty is clearly immoral.

Moral courage is required to use or not use "medical power." With that power comes a responsibility to use that power wisely and humanely for the benefit of these vulnerable children. We must continue to wrestle with the difficult questions at the bedside and as a society, but let's not struggle with a question that has a clear answer.

DR. ROBERT D. ORR, Director of Clinical Ethics

DR. RONALD PERKIN, Director of Pediatric ICU

DR. DAVED VAN STRALEN, Assistant Director of Pediatric, ICU

The writers are on staff at Loma Linda University Medical Center.

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