The Lazarus Case

Life-and-Death Issues in Neonatal Intensive Care

John D. Lantos

• Publisher: Johns Hopkins University Press
• Year: 2006
• eBook ISBN: 9780801876370
• Topic: Medicine
• Subtopic: Ethics & Professional Responsibility in Law

A gripping exploration of the legal and ethical dilemmas in neonatal intensive care—a truly original work.

Chosen as an Outstanding Academic Titles in 2003 by Choice Magazine

In this new, startlingly original book, John D. Lantos weaves a compelling story that captures the dilemmas of modern medical practice. The Lazarus Case: Life-and-Death Issues in Neonatal Intensive Care begins with a fictional malpractice case—an amalgam of typical cases in which Lantos appeared as an expert witness—and uses it as the framework for addressing the ethical issues surrounding neonatal intensive care. Lantos draws on his experience in neonatal medicine, pediatrics, and medical ethics to explore multiple ethical dilemmas through one poignant representative situation.

In Lantos's model case, a doctor decides to stop resuscitation of a premature infant, a tiny "preemie" who seems past reasonable care. The baby survives with severe neurological defects and the parents sue the doctor, alleging that stopping treatment was negligent. From this case, Lantos considers our moral obligations to critically ill babies, the meaning of negligence, and the sorts of social structures that shape the moral consciences of doctors.

Each chapter begins with Lantos deposing in the conference room of the plaintiffs' lawyers. The questions put to Lantos throughout the deposition spark an engrossing retelling of his personal experiences with premature babies, as well as his thoughtful discussions of ethics, morality, history, and medical statistics. Sprinkled throughout the book are references to fictional works by Camus, Dostoevsky, Shakespeare, Twain, and others. Lantos uses these literary examples to further illustrate the ambiguities, misunderstandings, responsibilities, and evasions that plague our decisions regarding life and death, medical care and medical education, and ultimately the cost and value of preserving the lives of the most vulnerable among us.

Table of contents

• Cover
• Title Page
• Copyright Page
• Dedication
• Contents
• Preface
• Acknowledgments
• 1 Somebody Will Pay
• 2 Passing Out in the NICU
• 3 Learning about Death and Dying
• 4 Standards of Care
• 5 Prognostication and Futility
• 6 Consent, Communication, Shared Decision Making
• 7 Getting Paid
• 8 Home Births
• 9 Mistakes in Context
• 10 Closing Argument
• Notes
• Index