The Consequences of Uncertainty:  An Empirical Approach to Medical Decision Making in Neonatal Intensive Care

Allen F. Fischer, MD; David K. Stevenson, MD
JAMA. 1987;258(14):1929-1931. doi:10.1001/jama.1987.03400140091031.
Text Size: A A A
Published online

BEFORE being struck down, the "Baby Doe" rule generated intense debate among those individuals who were interested in the ethical underpinnings of neonatal intensive care.1 The enormity of the gap between the attempt to regulate physician behavior and the reality in which such regulation was to occur was reflected in the implicit anonymity of the designation, Baby Doe. The treatment of many different conditions affecting individual patients could not possibly be regulated by a few general directives based on the anticipated outcome for the entire group. The ability to predict outcomes for individual, severely disabled infants is limited, even with precise knowledge of the infant's condition at birth.

To understand the difficulty in making decisions regarding the care of extremely premature neonates, it is imperative to understand the complex professional charge of the physician. As set forth in the Hippocratic tradition, the charge has two parts. The first is


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.