| Ethical decision-making in newborn infants. | |
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MedLine Citation:
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PMID: 9180056 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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One ethical dilemma which neonatologists are faced with on a regular basis is selective non-treatment, that is, clinical decisions made after the birth of a liveborn infant to withhold or to withdraw treatment in certain circumstances. Although the outcome of extremely preterm of critically ill infants has significantly improved over the last decade, many are often left to die at birth by withholding resuscitation or neonatal intensive care. Criteria for initiating life-sustaining treatment must be developed with proper ethical considerations. There are other infants whose clinical course after initiation of intensive care will suggest that further curative efforts are futile or lack compensating benefit. Criteria for withdrawing life-sustaining treatment must also be developed, and palliative care measures defined. Clinical situations in which selective non-treatment is taking place in neonatal medicine are: (1) when death is considered to be inevitable whatever treatment is provided, (2) even when death is not inevitable, there is a significantly high risk of severe physical and mental disability should the infant survive, and (3) when survival with moderate disability is possible, but the infant is likely to experience ongoing pain and suffering, repeated hospitalisation and invasive treatment, and early death in childhood. The decision-making process of selective non-treatment should involve less medical paternalism and more informed parental involvement. The process is built on trust between the neonatal staff and parents, and requires time, information, honesty and empathy. Ethical issues must be approached with extreme responsibility, extraordinary sensitivity and heroic compassion. |
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Authors:
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V Y Yu |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Acta médica portuguesa Volume: 10 ISSN: 0870-399X ISO Abbreviation: Acta Med Port Publication Date: 1997 Feb-Mar |
Date Detail:
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Created Date: 1997-07-31 Completed Date: 1997-07-31 Revised Date: 2004-11-18 |
Medline Journal Info:
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Nlm Unique ID: 7906803 Medline TA: Acta Med Port Country: PORTUGAL |
Other Details:
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Languages: eng Pagination: 197-204 Citation Subset: E; IM |
Affiliation:
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Serviço de Pediatria, Universidade de Monash, Melburne, Austrália. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Decision Making* Ethics Committees, Clinical Ethics, Medical* Euthanasia, Passive / legislation & jurisprudence Humans Infant, Newborn Internationality Neonatology* / legislation & jurisprudence Palliative Care Parental Consent Patient Selection Refusal to Treat / legislation & jurisprudence Uncertainty Withholding Treatment* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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