Terrible choices in the septic child: a response to the PALOH trial round table authors.

Journal of Medical Ethics
Joshua Parker, David Wright

Abstract

In this response article, we challenge a core assumption that lies at the centre of a round table discussion regarding the Pharmacogenetics to Avoid Loss of Hearing trial. The round table regards a genetic test for a variant (mt.1555A>G) that increases the risk of deafness if a carrier is given the antibiotic gentamicin. The idea is that rapid testing can identify neonates at risk, providing an opportunity to prevent giving an antibiotic that might cause deafness. We challenge the assumption that a positive test unequivocally guides antibiotic choice because, aside from the risk of deafness, all antibiotics for neonatal sepsis are equivalent. We argue that this assumption is faulty and has particularly troubling moral consequences. We claim that giving an alternative to gentamicin is potentially providing inferior treatment and thereby may increase the risk of death. Parents and doctors are faced with a terrible choice as a result of positive point-of-care testing (POCT): give gold-standard treatment and risk deafness or give second line care and risk death. While we do not indicate an answer to this choice, what we do argue is that such a deep and difficult choice is one that may make parents wish genetic testing was never und...Continue Reading

References

Apr 1, 1959·A.M.A. Archives of Otolaryngology·R F NAUNTON, P H WARD
Apr 27, 2011·Pediatrics·Barbara J StollUNKNOWN Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
Dec 6, 2011·Clinical Ethics·Julian Savulescu, Guy Kahane
Jul 12, 2020·Journal of Medical Ethics·John Henry McDermott
Jul 15, 2020·Journal of Medical Ethics·Peta Coulson-Smith, Anneke Lucassen
Jul 16, 2020·Journal of Medical Ethics·William G Newman
Jul 17, 2020·Journal of Medical Ethics·Margot R Brazier

❮ Previous
Next ❯

Citations


❮ Previous
Next ❯

Related Concepts

Related Feeds

Auditory Perception

Auditory perception is the ability to receive and interpret information attained by the ears. Here is the latest research on factors and underlying mechanisms that influence auditory perception.

Related Papers

American Journal of Medical Genetics. Part a
Richard J H Smith
Clinical Chemistry and Laboratory Medicine : CCLM
Urs E NydeggerThierry Carrel
Nihon Naika Gakkai zasshi. The Journal of the Japanese Society of Internal Medicine
Naoto Shimetani
The Western Journal of Medicine
J J Bonica
© 2021 Meta ULC. All rights reserved