Trisomy 18 and Complex Congenital Heart Disease: Seeking the Threshold Benefit abstract A prenatal diagnosis of ductal-dependent, complex congenital heart

A prenatal diagnosis of ductal-dependent, complex congenital heart disease was made in a fetus with trisomy 18. The parents requested that the genetic diagnosis be excluded from all medical and surgical decision-making and that all life-prolonging therapies be made available to their infant. There was conflict among the medical team about what threshold of neonatal benefit could outweigh maternal and neonatal treatment burdens. A prenatal ethics consultation was requested. Pediatrics 2013;132:161–165 AUTHORS: Renee D. Boss, MD, MHS,ab Kathryn W. Holmes, MD, MPH,c Janyne Althaus, MD,a Cynda H. Rushton, PhD, RN,bd Hunter McNee, and Theresa McNee aDepartment of Pediatrics, Johns Hopkins University School of Medicine, bJohns Hopkins Berman Institute of Bioethics, and dDepartment of Acute and Chronic Care, Johns Hopkins University School of Nursing, Baltimore, Maryland; and cDepartment of Pediatrics, Oregon Health and Science University, Portland, Oregon