Death or Disability? The 'Carmentis Machine' and decision-making for critically ill children

In ancient Rome parents would consult the priestess Carmentis shortly after birth to obtain prophecies of the future of their newborn infant. Today, parents and doctors of critically ill children consult a different oracle. Neuroimaging provides a vision of the child's future, particularly of the nature and severity of any disability. Based on the results of brain scans and other tests doctors and parents face heart-breaking decisions about whether or not to continue intensive treatment or to allow the child to die. Paediatrician and ethicist Dominic Wilkinson looks at the profound and contentious ethical issues facing those who work in intensive care caring for critically ill children and infants. When should infants or children be allowed to die? How accurate are predictions of future quality of life? How much say should parents have in these decisions? How should they deal with uncertainty about the future? He combines philosophy, medicine and science to shed light on current and future dilemmas.

Dominic Wilkinson is Associate Professor of Neonatal Medicine and Bioethics at the University of Adelaide, and a senior research associate of the Oxford Uehiro Centre for Practical Ethics. He has worked as a doctor in neonatal, paediatric and adult intensive care, and is currently consultant neonatologist at the Women's and Children's Hospital in Adelaide. He has a DPhil in medical ethics from the University of Oxford, and has written a large number of academic articles relating to ethical issues in intensive care.