Prof. John Lantos

1. Medical error

a. Carter BS, Lantos JD. Disclosing adverse events and near misses to parents of neonates. Semin Perinatol. 2019 Dec;43(8):151182. doi: 10.1053/j.semperi.2019.08.011.

b. Bell SK, Mann KJ, Truog R, Lantos JD. Should we tell parents when we've made an error? Pediatrics. 2015 Jan;135(1):159-63. doi: 10.1542/peds.2014-0293

c. Antiel RM, Blinman TA, Rentea RM, Gonzalez KW, Knott EM, Juang D, Oyetunji T, Holcomb GW 3rd, Angelos P, Lantos JD. When a Surgical Colleague Makes an Error. Pediatrics. 2016 Mar;137(3):e20153828. doi: 10.1542/peds.2015-3828.

d. Kidszun A, Linebarger J, Walter JK, Paul NW, Fruth A, Mildenberger E, Lantos JD. What If the Prenatal Diagnosis of a Lethal Anomaly Turns Out to Be Wrong? Pediatrics. 2016 May;137(5):e20154514. doi: 10.1542/peds.2015-4514.

 

2. Neonatal Clinical Care. A major focus of my work is on ethical issues in neonatal intensive care and the need to make clinical decisions in situations of prognostic uncertainty. My research in this area includes an array of issues, including end of life decisions, examination of both the accuracy of diagnoses and prognoses, and implicit biases associated with clinical decisions based on these epidemiological facts.  Representative publications:

a. Lantos JD. Baby Doe five years later: Implications for child health. N Eng J Med 1987 Aug 13;317(7):444-7 PMID: 2956518

b. Lantos JD, Miles SH, Silverstein M, Stocking CL.  Outcome after cardiopulmonary resuscitation in babies of very low birth weight: Is CPR futile therapy. New Engl J Med 1988 Jan 14;318(2):91-95 PMID: 3336398

c. Singh J, Lantos JD, Meadow WL.  End of Life After Birth: death and dying in a neonatal intensive care unit. Pediatrics 2004 Dec;114(6):1620-5  PMID: 15574624

d. Brunkhorst J, Weiner J, Lantos J. Infants of borderline viability: the ethics of delivery room care. Semin Fetal Neonatal Med. 2014 Oct;19(5):290-5. doi: 10.1016/j.siny.2014.08.001. Epub 2014 Aug 19.

 

3. Pediatrics Research Ethics. My focus expanded to the ethics of research and innovative therapy in pediatrics.  Here, I studied the ethical issues associated with various innovative therapies, including ECMO, bone marrow transplantation, growth hormone, and artificial hearts.  The central questions here is when do we know enough to say that we know enough, and no longer need to study innovation but should, instead, adopt it as standard therapy.  Representative publications:

a. Singer P, Lantos JD, Siegler M, Broelsch C, Whittington P. Equipoise and the Ethics of Segmental Liver Transplantation. Clin Res 1988 Oct;36(6):539-45 PMID: 3053006

b. Kodish E, Lantos JD, Siegler M.  Ethical Considerations in Randomized Controlled Clinical Trials. Cancer 1990 May 15;65(10 Suppl):2400-4 PMID: 2185875

c. Lantos JD, Frader J. Extracorporeal membrane oxygenation and the ethics of clinical research in pediatrics. N Engl J Med 1990 Aug 9;323(6):409-13 PMID: 2196466

d. Lantos JD, Spertus JA. The concept of risk in comparative-effectiveness research. N Engl J Med. 2014 Nov 27;371(22):2129-30 PMID: 25390458

 

4. Adolescents. Clinical treatment of and research with adolescents raise unique dilemmas. This is especially the case in contexts where adolescents’ medical needs and interests are different than those of their parents such as in the case of parental religious beliefs and teens’ pregnancy. My work on adolescents has focused on decision making, including analyses of teens’ trust in emergency department doctors, decisions regarding menstrual suppression among teens with intellectual disabilities, and ethical issues associated with emergency contraception.  More recently I also investigated challenges relating to the growing concern of violence by adolescents and the role of clinicians in assessing such risks. Representative publications:

a. Rousseau C, Ellis BH, Lantos JD. The Dilemma of Predicting Violent Radicalization.  Pediatrics. 2017 Oct;140(4). pii: e20170685. doi: 10.1542/peds.2017-0685.

b. Ellis KL, Randell K, Lantos J, Miller MK. Trust in the Medical Profession Among Adolescents in an Emergency Department.  Pediatr Emerg Care. 2017 May 15. doi: 10.1097/PEC.0000000000001133.

c. Plantz D, Lantos JD. Conscience, clinical ethics, and emergency contraception.  Adolesc Med State Art Rev. 2011 Aug;22(2):175-82,

d. Curlin FA, Lawrence RE, Chin MH, Lantos JD. Religion, conscience, and controversial clinical practices. N Engl J Med. 2007 Feb 8;356(6):593-600.

 

5. Preterm Birth and Prenatal care. I have also studied the rising rate of preterm birth and the implications of changes in prenatal care on the incidence of medically induced-preterm birth. This work examines the way pregnant women, including adolescents, and their doctors make decisions during the prenatal period.  It focuses on the emerging science of fetal medicine as an innovative diagnostic and therapeutic technology that has subtly changed the meaning of preterm birth.  Among other things, we highlight the seeming paradox that, over the last thirty years, both infant mortality and fetal mortality have steadily declined, even as the rate of preterm birth rises.  These trends are likely to continue, and even accelerate, with advances in genomics and personalized medicine.  Representative publications:

a. VanderWeele TJ, Lauderdale DS, Lantos JD. Medically induced preterm birth and the associations between prenatal care and infant mortality.  1Ann Epidemiol 2013 Jul;23(7):435-40 PMID: 23726822

b. Siddique J, Lantos JD, VanderWeele TJ, Lauderdale DS. Screening tests during prenatal care: does practice follow the evidence?  Matern Child Health J.  2011 Jan;16(1):51-9 PMID: 21113814

c. Lauderdale DS, Vanderweele TJ, Siddique J, Lantos JD. Prenatal Care Utilization in Excess of Recommended Levels: Trends from 1985 to 2004.  Med Care Res Rev 2010 Oct;67(5):609-22 PMID: 19915067

 

6. Genomics and Newborns. The past decade has seen a tremendous growth in the number of genetic testing that are offered to newborns. This development has enabled pediatricians to better understand the clinical picture of their pediatric patients and to make change in the course of treatment or to offer preventative measures that can significantly reduce the risks for newborns to develop various medical conditions. As next-generation sequencing technologies continue to emerge, there is an urgent need to consider how such extensive information may impact clinical care for newborns and families. In this regard, I chaired the working group on Ethical, Legal and Social Issues of the NHGRI-funded NSIGHT Consortium, a group that is investigating scientific, clinical and ethical issues in genome sequencing for newborns, and I have analyzed ethical issues that arise in the use of genomic sequencing for both diagnosis and for therapy in newborns. Representative publications:

a. Lantos JD. Introduction to Bioethics Special Supplement V: Ethical Issues in Genomic Testing of Children. Pediatrics. 2016 Jan;137 Suppl 1:S1-2. doi: 10.1542/peds.2015-3731B

b. Thiffault I, Lantos J. The Challenge of Analyzing the Results of Next-Generation Sequencing in Children.  Pediatrics. 2016 Jan;137 Suppl 1:S3-7. doi: 10.1542/peds.2015-3731C.

c. Bos W, Westra AE, Pinxten W, Mayer MP, Lantos JD. Risks in a Trial of an Innovative Treatment of Duchenne Muscular Dystrophy. Pediatrics. 2015 Dec;136(6):1173-7. doi: 10.1542/peds.2015-1589

d. Char DS, Lazaro-Munoz G, Barnes A, Magnus D, Deem MJ, Lantos JD.  Genomic Contraindications for Heart Transplantation.  Pediatrics, 2017.  In press.

 

Complete List of Published Work in MyBibliography: http://www.ncbi.nlm.nih.gov/sites/myncbi/1X7y-jp1hcIkh/bibliograpahy/48216669/public/?sort=date&direction=descending

 

1. Glasnapp Family Foundation Endowed Chair in Bioethics, Oct 2019

2. William Bartholome Award for Ethical Excellence, American Acad of Peds, 2018

3. Wings of Audrey Award, University of Oklahoma, 2019

4. Paul Contini Lecture, Harvard University, May 2018

5. L. J. Filer Endowed Lecture. University of Iowa. May 2016

6. Thelma Shobe Endowed Lecturer, UCSF, Feb 2016

7. Pellegrino Medal for contributions in healthcare ethics, HEAL Conference, Samford University, Birmingham, Alabama, 2012

8. March of Dimes Endowed Lecture, Perinatal Bioethics, American Society of Bioethics and Humanities, 2009

9. Member of Honor, Society of Ibero-American Neonatologists (SIBEN) September, 2009

10. Arthur Koppelman Endowed Lectureship, Brody School of Medicine, 2008

11. Inaugural speaker, Treuman Katz Lectureship, Children’s Hospital of Seattle, 2007

12. Named one of the best pediatricians in the Midwest, Ladies Home Journal, 2001

13. Named one of Chicago’s Best Pediatricians. Chicago Magazine, 2000, 2002, 2003, 2006, 2007, 2008

14. Community Peacemaker Award from The Peace Museum, Chicago. 1996

15. Certified Mohel, National Organization of American Mohelim/mohelot. 1992

16. Honorable Mention, Nellie Westerman Prize in Research  Ethics, American Federation for Clinical Research, 1990

17. Nellie Westerman Prize for Research in Ethics, American Federation for Clinical Research, 1988

18. E. Clarence Rice Award for Excellence in Medical Writing, Children's National Medical Center, Washington, DC, 1984

19. Richard L. Day Award for outstanding student in the Class of 1981 in Pediatrics. University of Pittsburgh School of Medicine, 1981

20. Joseph Heidenkamp Award, given to the outstanding student in the class of 1981 in Child Psychiatry, University of Pittsburgh School of Medicine, 1981

21. Medical Student Award of the Allegheny County Medical Society for Academic Excellence and distinction in the Medical Scientist Exchange Program, 1980