We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Commentary |

Healthcare Providers Must Offer Palliative Treatment to Parents of Neonates With Hypoplastic Left Heart Syndrome

Alexander A. Kon, MD
Arch Pediatr Adolesc Med. 2008;162(9):844-848. doi:10.1001/archpediatrics.2008.3.
Text Size: A A A
Published online


Hypoplastic left heart syndrome (HLHS) affects approximately 1000 infants annually in the United States.1,2 Several treatment options exist, including the staged surgical approach,3 cardiac transplantation,4 banding of the pulmonary arteries,5 in utero balloon valvuloplasty,6 and other novel and experimental techniques aimed at prolonging life and minimizing sequelae.7 Alternatively, parents may believe that the burdens of these interventions outweigh the benefits and may decide that it is in their child's best interest to pursue care that minimizes suffering without prolonging life. Such management has previously been termed comfort care. However, for reasons that will be described, it should be more properly referred to as palliative treatment and I will therefore refer to it as such. However, whether palliative treatment should be offered remains hotly debated. Many physicians do not discuss this option with parents,8 and some argue that this option should never be offered and that all infants with HLHS should have treatment aimed at prolonging life.9

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

20 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles