Column Editor’s note:  This column presents a problematic case that poses a medical-ethical dilemma for patients, families, and healthcare professionals.  As it is based on a real situation, some details have been changed in the effort to maintain confidentiality.  In this case, the community pediatric society struggles with appropriate pediatric care in the face of considerable financial constraints.

Column editor: 
Ferdinand D. (Nick) Yates, Jr., MD, MA, Acting Consultant in Clinical Ethics, CBHD

If you say, “But we knew nothing about this,” does not he who weighs the heart perceive it?
--Proverbs 24:12a

Starting from an uncut paper square and proceeding through a series of careful folds, origami master Brian Chan has fashioned a detailed replica of the human brain, which he displays on his website.¹ Art imitates nature as tissue paper patterns the shape of living tissue. The fine wrinkles and fragile creases of Chan’s extraordinary model depict the brain’s intricate ordering and delicate construction.

 “How could physician healers have turned into murderers?  This is among the most profound questions in medical ethics.”¹

“How could men and women sworn to the Hippocratic oath, trained as professionals in the world’s most advanced scientific culture, come to commit crimes that even today stand as exemplars of evil?”²