Doctor and parents have conflicting views and wishes in designing treatment plan for an 18-month-old child, critically ill with a rare form of pediatric cancer. Commentary by Joal Hill, JD, MPH Jonathan Roland, an 18-month-old boy diagnosed with a rare form of pediatric cancer 4 months ago, is critically ill. Initial chest surgery and chemotherapy went well, but complications developed 3 months into treatment. His parents agreed to emergency surgery, even though Jonathan was at high risk for

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... orrhaging because of the medications used for his cancer treatment. This complication did occur, and Jonathan went into shock. He was placed on extra corporeal membrane oxygenation (ECMO), but has not done well. Because of swelling and infection, his surgical wound is open, and he remains at risk for bleeding, which greatly complicates routine care.