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  • Letter to the Editor
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Response to ‘Withdrawal of life-sustaining treatment in the first year of life’

Journal of Perinatology volume 29, pages 328–329 (2009)Cite this article

We thank Drs Bosslet and Helft for continuing the conversation on the withdrawal of support from critically ill infants. It is important to understand that in presenting essentially a case report of six patients, our goal was to describe the Medical Appropriateness Review Committee (MARC) and the kind of cases referred to it, rather than critique the actual cases.

We agree with Boslett and Helft that race can be an important consideration, and we reported our demographic data appropriately in the results section as it might be important to readers. In Houston, 70% of the population is African–American and Hispanic, and national data consistently show that African–Americans are disproportionately represented in prematurity and other medical problems requiring admission to an Neonatal Intensive Care Unit (NICU). The admission population of our (NICU) during the study period was 41% African–American, 25% Hispanic, 31% White and 3% others. For Pediatric Intensive Care Unit (PICU) admissions, 24% were African–American, 33% Hispanic, 33% White and 1% others. With such small numbers referred to the MARC from each unit, it is difficult to show statistical confidence, but we share concerns of over-representation of African–Americans in the cases referred to the MARC.

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Authors and Affiliations

  1. Private Practice, Houston, TX, USA

    E B Eason

  2. Department of Internal Medicine, Pulmonary and Critical Care and Sleep Medicine, University of Texas–Houston Medical School, Houston, TX, USA

    R J Castriotta

  3. Clinical Ethics, Memorial Hermann Hospital, Houston, TX, USA

    V D Gremillion

  4. Department of Pediatrics, 982165 Nebraska Medical Center, Omaha, NE, USA

    J W Sparks

Authors
  1. E B Eason
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  2. R J Castriotta
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  3. V D Gremillion
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  4. J W Sparks
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Correspondence to J W Sparks.

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Eason, E., Castriotta, R., Gremillion, V. et al. Response to ‘Withdrawal of life-sustaining treatment in the first year of life’. J Perinatol 29, 328–329 (2009). https://doi.org/10.1038/jp.2009.7

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