Counseling families and deciding care of severely defective children: a way of coping with 'Medical Vietnam'.

Medical paternalism supported by hospitals and courts has been, will be, and should be used in those few situations where clearly incompetent or irresponsible parents resist treatment that health professionals generally agree is needed and effective. If used in other circumstances, it is likely to erode family and professional autonomy and bring about an oppressive "medical Vietnam" (costly, sometimes abusive, use of technology to ensure biologic existence with little regard for quality of child and family life and competing interests). Families must be relied upon to help resolve most complex tragedies because there is no better alternative. They are likely to become stronger if they participate in decisions for care of their severely defective children. Such decisions logically include those for life or death.