Ethical Issues In Neonatal Intensive Care Units.
Adult; Attitude Of Health Personnel; Child; Europe; Euthanasia Passive/ethics; Humans; Infant Newborn; Intensive Care Neonatal/ethics; Italy; Morals; Parents; Withholding Treatment/ethics
Recent progress in neonatal care have significantly improved the prognosis and chances of survival of critically ill or extremely preterm neonates and have modified the limits of viability. However, in some circumstances, when the child's death can only be briefly postponed at the price of severe suffering, or when survival is associated with severe disabilities and an intolerable life for the child and his/her parents, the application of the full armamentarium of modern neonatal intensive care may not be appropriate. In such circumstances the limitation of intensive treatments (withholding or withdrawing) and shift towards palliative care, can represent a more humane and reasonable alternative. This article examines and discusses the ethical principles underlying such difficult decisions, the most frequent situations in which these decisions may be considered, the role of parents in the decisional process, and the opinions and behaviours of neonatologists of several European neonatal intensive units as reported by the EURONIC study.
Liu J; Chen X; Wang XL
Journal Of Maternal, Fetal And Neonatal Medicine
2016
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
DOI: 10.4415/ANN_11_03_06
Low prevalence of palliative care and ethics consultations for children with chronic critical illness
Medical advances over the past two decades have increased the numbers of children who survive serious conditions. Mortality from pre-mature birth and genetic syndromes has improved such that more clinicians offer, and more families request, interventions to prolong their child’s life. While some interventions promise cure, others result in chronic disease states that require ongoing medical care. Paediatric intensive care units (ICUs) across the United States (U.S.) report increasing numbers of children with prolonged and recurrent hospitalisations and medical complexity(1). We have suggested that this population be considered ‘chronically critically ill (CCI)’ (2).The CCI designation for adult ICU patients signals to families and clinicians alike that thepatient’s prognosis is poorer than predicted by their primary diagnosis alone. Nelson et al. (3) have argued that palliative care can enhance care planning, communication and quality of life for patients with CCI. The ethical challenges that can arise for these patients, for example, conflicting values and treatment burdens, also highlight an obvious role for ethics consultation.
Xu L; Gao H; Zeng J; Liu J; Lu C; Guan X; Qian S; Xie Z
BMC Infectious Diseases
2018
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1111/apa.14394" target="_blank" rel="noreferrer noopener">10.1111/apa.14394</a>