Should Physicians Offer a Ventricular Assist Device to a Pediatric Oncology Patient With a Poor Prognosis?

Angira Patel; Anna Joong; Efrat Lelkes; Jeffrey G Gossett

doi:10.1001/amajethics.2019.380

Should Physicians Offer a Ventricular Assist Device to a Pediatric Oncology Patient With a Poor Prognosis?

AMA J Ethics. 2019 May 1;21(5):E380-386. doi: 10.1001/amajethics.2019.380.

Authors

Angira Patel¹, Anna Joong², Efrat Lelkes³, Jeffrey G Gossett⁴

Affiliations

¹ A pediatric and fetal cardiologist at the Ann and Robert H. Lurie Children's Hospital of Chicago in Illinois.
² A pediatric heart failure and transplant physician at the Ann and Robert H. Lurie Children's Hospital of Chicago in Illinois.
³ A pediatric intensive care unit physician and palliative care specialist at the UCSF Benioff Children's Hospital San Francisco.
⁴ The medical director of pediatric heart failure, mechanical circulatory support, and heart transplantation services at the UCSF Benioff Children's Hospital San Francisco.

PMID: 31127916
DOI: 10.1001/amajethics.2019.380

Abstract

A case is presented of a 10-year-old girl with refractory leukemia with poor prognosis and chemotherapy-induced heart failure. She is evaluated for a ventricular assist device (VAD), but the pediatric heart failure team views VAD as clinically inappropriate due to her active oncologic problems. This article examines ethical concerns that arise in deciding whether to offer and use this technology.

Publication types

Case Reports

MeSH terms

Antineoplastic Agents / adverse effects
Antineoplastic Agents / therapeutic use
Child
Dissent and Disputes
Family / psychology*
Female
Heart Failure / chemically induced*
Heart-Assist Devices / ethics*
Humans
Leukemia, Myeloid, Acute / drug therapy*
Medical Futility / ethics*
Pediatrics / ethics
Physicians / ethics*
Prognosis

Substances

Antineoplastic Agents