Futility in the NICU

In a recent issue of the Journal of Perinatology, Mark Mercurio describes how the pediatric ethics committee at Lawrence & Memorial Hospital handled a medical futility dispute.  The patient's parents agreed to withhold chemotherapy "because it offered no benefit to [Katherine], and might possibly hurt her."  But the parents would not consent to DNAR even though CPR would probably not work and even if it did it would only "extend her life by minutes (this is, vital signs briefly restores)" and those "could be very painful minutes."  Mercurio argues that CPR should never have been offered in the first place.  But it was.  

The neonatology attending ultimately invoked the hospital's "Conscientious Practice Policy."  The ethics committee agreed that the team was "not obligated to provide CPR."  The CPP procedure next required a decision from the Chief of Staff.  He agreed with the ethics committee.  The DNR order was written.  The parents did not challenge that decision in court.