LAUSR

This Ethics Rounds article discusses whether to consider a family’s economic circumstances when recommending an expensive treatment. Poor families without health insurance present unique challenges for pediatricians who want to do what is best for the children who are their patients. Families are often willing to make tremendous sacrifices to pay for recommended and needed medical care. Physicians may have to decide whether, or how strongly to, recommend expensive treatments, especially when any good outcomes associated with such treatments are not guaranteed. How should we balance the considerations of justice and of the child’s best interest with the grim realities facing poor families? In this article, we present a case from a tertiary care hospital in India in which doctors and parents struggled to figure out the best options for a young man with end stage renal disease.