The Lazarus Case: Life-and-Death Issues in Neonatal Intensive Care

by John D. Lantos

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 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.

Genres: Medicine, Medical

208 pages, Paperback

First published October 26, 2001

About the author

John D. Lantos is Professor of Pediatrics at the University of Missouri at Kansas City and Director of the Children's Mercy Hospital Bioethics Center.

Reviews

[Hailey Hauck]

Favorite quotes below:

“On the one hand, it seemed like you just had to be there to understand and that those who hadn’t been there were in no position to judge. On the other hand, things looked so much clearer from far away, where the events could become stories, the stories could become cases, and the cases led to decisions, precedents, rules, and regulations. Like a pointillist painting or constellation, things might make more sense when seen from far away”

“The modern approach differs from ancient codes in imagining that the doctor has an obligation, not to the patient’s health, but to the patient’s desires”

“Unless of course, the relevant consents here were not that of the mother and father but that of the babies. What would they want — the delivery that made their parents the happiest or the one that had the statistically lowest risk?”

“I cared for children with the sort of complex chronic diseases that impoverish their parents and make them unwelcome in private practices”

[Faith]

A fascinating discussion of ethical issues involved in the care of premature infants told through the lens of a (fictionalized) malpractice case. Lantos is an excellent writer and the book is thought-provoking and at times uncomfortable.

[Sharon]

Excellent read for anyone interested in medical ethics. I think it's written so non-professionals could engage easily in the material. Definately addresses important questions we in the neonatal field should be pondering.

[TJ]

One ethicist tale of a specific case viewed in light of his experiences. Not as helpful for understanding the ethics or greater issues of preemies

Social Health Care Ethics

[Valerie]

Not a light read but very intriguing and thought provoking. It didn't focus on neo-natal intensive care as much as I was expecting, but I really enjoyed this book.