A post-mortem population survey on foetal-infantile end-of-life decisions: a research protocol

Title

A post-mortem population survey on foetal-infantile end-of-life decisions: a research protocol

Creator

Dombrecht L; Beernaert K; Roets E; Chambaere K; Cools F; Goossens L; Naulaers G; De Catte L; Cohen J; Deliens L

Publisher

BMC Pediatrics

Date

2018

Subject

Neonates; End-of-life decisions; Mortality follow-back survey; Population-based; Stillbirths; Termination of pregnancy

Description

BACKGROUND: The death of a child before or shortly after birth is frequently preceded by an end-of-life decision (ELD). Population-based studies of incidence and characteristics of ELDs in neonates and infants are rare, and those in the foetal-infantile period (> 22 weeks of gestation - 1 year) including both neonates and stillborns, are non-existent. However, important information is missed when decisions made before birth are overlooked. Our study protocol addresses this knowledge gap. METHODS: First, a new and encompassing framework was constructed to conceptualise ELDs in the foetal-infantile period. Next, a population mortality follow-back survey in Flanders (Belgium) was set up with physicians who certified all death certificates of stillbirths from 22 weeks of gestation onwards, and infants under the age of a year. Two largely similar questionnaires (stillbirths and neonates) were developed, pilot tested and validated, both including questions on ELDs and their preceding decision-making processes. Each death requires a postal questionnaire to be sent to the certifying physician. Anonymity of the child, parents and physician is ensured by a rigorous mailing procedure involving a lawyer as intermediary between death certificate authorities, physicians and researchers. Approval by medical societies, ethics and privacy commissions has been obtained. DISCUSSION: This research protocol is the first to study ELDs over the entire foetal-infantile period on a population level. Based on representative samples of deaths and stillbirths and applying a trustworthy anonymity procedure, the research protocol can be used in other countries, irrespective of legal frameworks around perinatal end-of-life decision-making.

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here.

Citation List Month

October 2018 List

Pages

260-260

Issue

1

Volume

18

Collection

Citation

Dombrecht L; Beernaert K; Roets E; Chambaere K; Cools F; Goossens L; Naulaers G; De Catte L; Cohen J; Deliens L, “A post-mortem population survey on foetal-infantile end-of-life decisions: a research protocol,” Pediatric Palliative Care Library, accessed December 7, 2021, https://pedpalascnetlibrary.omeka.net/items/show/15590.

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