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September 2019 List
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September 2019 List
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<a href="http://doi.org/10.1016/j.arcped.2019.06.007" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.arcped.2019.06.007</a>
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The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Neonatal end-of-life decision-making almost 20 years after the EURONIC study: A French survey
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Archives de Pediatrie
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2019
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Decision-making process; French end-of-life law; Neonates; Withholding and withdrawing life-sustaining treatment
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Boize P; Borrhomee S; Michel P; Betremieux P; Hubert P; Moriette G
Description
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Nearly 20 years ago the EURONIC study reported that French neonatologists sometimes deemed it legitimate to terminate the lives of newborn infants when the prognosis appeared extremely poor. Parents were not always informed of these decisions. Major change has occurred since then and is described herein. MATERIAL AND METHODS: A survey was conducted in the Ile-de-France region, from 1 January to 31 January 2016. Professionals from 15 neonatal intensive care units (NICUs) were invited to complete a questionnaire. RESULTS: A total of 702 questionnaires were collected and 670 responses were analyzed. Knowledge of the law differed according to professional status, with 71% of MDs (medical staff, MS), compared with 28% of nonmedical staff (NMS) declaring that they had good knowledge of the law. Most MDs and NMS believed that withholding or withdrawing life-sustaining treatments (WWLST) could be decided and implemented after a delay. Half of them thought that WWLST would always result in death. Although required by law, a consulting MD attended the collegial meeting required before deciding on WWLST in only half of the cases. Parents were almost always informed of the decision thereafter by the physician in charge of their infant. The most frequent disagreement with parents was observed when WWLST was the option selected. In this case, most professionals suggested postponing WWLST, continuing intensive care and dialogue with parents, aiming at a final shared decision. Major differences were observed between NICUs with regard to the withdrawal of artificial nutrition and hydration. Finally, 14% of MDs declared that infant active terminations of life still occurred in their NICU. Major differences concern WWLST and active termination of life, whose meaning has been partly modified since 2001. CONCLUSION: Several major changes were observed in this survey: (1) treatment withdrawal decisions are made today in agreement with the law; (2) parents' information and involvement in the decision process have profoundly changed; (3) active termination of life (euthanasia) very rarely occurs; only at the end of a process in accordance with ethical principles and within the law is this decision made.
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<a href="http://doi.org/10.1016/j.arcped.2019.06.007" target="_blank" rel="noreferrer noopener">10.1016/j.arcped.2019.06.007</a>
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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).
2019
Archives de Pediatrie
Betremieux P
Boize P
Borrhomee S
Decision-making process
French end-of-life law
Hubert P
Michel P
Moriette G
Neonates
September 2019 List
Withholding and withdrawing life-sustaining treatment