The Lazarus Case

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

John D. Lantos

Johns Hopkins University Press

ISBN-13: ‏978-0801887703

In this new, startlingly original book, John D. Lantos weaves a compelling story that captures the dilemmas of modern medical practice. The Lazarus Case: 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.

Reviews

"Compelling. Lantos's narrative style makes for pleasurable reading; once you start a given chapter it is difficult to put his book down. He is at his best when sharing his personal experiences in the clinical realm and insights from relevant nonmedical literature. I am confident it will generate important discussions within our group that will benefit each of us and the infants and families we care for." - Journal of the American Medical Association

"Lantos has taken an important practical problem and applied our understanding of moral and ethical theory to the issue of the appropriateness of care. An important message here is that in the context of this particular case, there are no right or wrong answers to questions posed." - New England Journal of Medicine

"In this startlingly original book, John D. Lantos weaves a compelling story that captures the dilemmas of modern medical practice. The Lazarus Case begins with a fictional malpractice case--an amalgam of typical cases in which Lantos has testified 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." - Felicia G. Cohn

About the Author

John Lantos Portrait

John Lantos grew up in the rugged mountains of western Pennsylvania coal country. His father, a physician, was his childhood hero and role model.  His mother, a poet at heart, inspired him to become a writer.  He is an award-winning pediatrician, a prolific author, a beloved teacher, and an inspirational speaker.

 

Lantos was a resident in DC during the national controversy about Baby Doe, a baby with Down Syndrome.  That sparked a lifelong interest in bioethics and led to a post-doc fellowship at The University of Chicago. There, his groundbreaking work on neonatal bioethics and health policy led to leadership roles as Chief of General Pediatrics and Associate Director of the MacLean Center for Clinical Medical Ethics, and Associate Editor of Pediatrics.  Fifteen years ago, he moved to Kansas City to create and develop the Children’s Mercy Bioethics Center.