Editors' Note

Abstract

Editors' Note James M. DuBois, Ana S. Iltis, and Heidi A. Walsh Dionne Deschenne was 30 weeks pregnant with her son when she contracted a serious case of pneumonia, requiring her to have an emergency C-section. Her son spent weeks in the NICU after his premature birth. Deschenne writes, "Under the conditions, I relied on the hospital staff to help me understand the risks, benefits, and necessities of each procedure or test they recommended. We formed a relationship of mutual respect." One day when Deschenne's doctor was making rounds, a nurse asked if she wanted to have her son circumcised while the doctor had time and was available. "The nurse bringing up circumcision was one with whom I had built a relationship of trust over the previous days. I considered her a trusted advisor. I asked her what the benefits would be? What would the risks be? Would my son experience pain? Was operating on such a tiny and ill baby safe?" Authors in this issue of "Narrative Inquiry in Bioethics" pondered similar questions. In the symposium, "Newborn Male Circumcision," we aimed to explore the decision making process of parents when choosing whether to have their infant male children circumcised. Through the symposium, we hoped to gain insights about what information or resources parents lack or would find helpful as they decide. "Overall, even though it was a very difficult decision, I think it was the right one for my son and our family," says Anonymous Two, one of 14 authors who contributed a story. "I don't think it's right for others to judge parents that make the choice to circumcise their sons. I don't think it's an easy choice for most of them—it certainly wasn't an easy choice for me." Twelve stories are included in the symposium; two additional narratives are published in the online supplement. Nine of the 12 parent authors opted to circumcise their infant sons, though the reasons they stated for doing so varied. Most of the parent authors relied on cultural or social beliefs, religious guidance, or a desire for sameness with the infant's father. Parents who didn't circumcise their male infants discuss their convictions about autonomy, bodily rights, and the medical benefits of circumcision versus the harm or pain caused by the procedure. The symposium editor, Heidi A. Walsh, makes the observation that "while shared decision making is not an overarching theme in the stories, the authors demonstrate that circumcision decisions are not straightforward for many parents and discussion with a trusted healthcare provider could have been helpful." The four commentary articles by Lauren L. Baker, Laura M. Carpenter, Shawn D. O'Connor and Claudio J. Kogan offer important insights into the authors' stories. Comatose survivors of cardiac arrest often die after life-sustaining therapy is withdrawn. Family members, acting as surrogate decision makers, are frequently asked to decide whether their loved one should continue to receive ongoing mechanical ventilation or other life-sustaining therapy considering the high risk of death once this therapy is withdrawn. Sometimes, physicians and family members disagree about what is in the patient's best interest, which causes distress for both families and healthcare providers. "Physician Family Conflict [End Page vii] Following Cardiac Arrest: A Qualitative Study" written by Rachel Caplan et. al., examines themes recorded in the medical records of 24 cardiac arrest patients whose families indicated that they wanted to pursue continued life support for their family member, despite the physician's recommendation to withdraw life-sustaining therapy. In documented conversations between family members and healthcare providers, four prominent themes family members cited for not wanting to withdraw life support emerged, including faith in miracles, the inappropriateness of "playing God," the value of more time with the patient, and differences in how providers and family members perceive the patient's status. The authors conclude that by listening carefully, asking questions, and engaging in conversation, clinicians may help reduce conflict, improve communication, and help families make the best decision for the patient. The case study in this issue was written by Leenoy Hendizadeh et al. and was submitted as part of our case study partnership with Kaiser Permanente...