[Thanishiya Maduray]

#85968

I agree that this can be a difficult decision, there is no easy framework to base the decision on, only to look at the four pillars of medical ethics and balance that with the resources of our hospital/ province. Most recently we have a baby diagnosed with Trisomy 21 and AVSD in cardiac failure, oxygen dependent from birth in the NICU and failing to thrive. Last year we had a similar patient and we delayed limiting care, hoping there would be improvement, meds would help, cardiology would be able to take over. However there was no improvement after many months and it was tough to counsel the caregiver when we had given her so much hope in the months preceding – it was almost a shock to her. Now we realise we need to be realistic and ensure the caregiver is aware earlier that there is a poor prognosis especially in KZN where children with Trisomy 21 and cardiac lesions are a lower priority for corrective surgery (justifiably, unfortunately).