It is our goal in formulating these guidelines, and the ATA’s goal in providing support for the development of these guidelines, that they assist in the clinical care of patients, and share what we believe is current, rational, and optimal medical practice. In some circumstances, it may be apparent that the level of care recommended may be best provided in limited centers with specific expertise. Finally, it is not the intent of these guidelines to replace individual decision making, the wishes of the patient or family, or clinical judgment.