Ethical decision-making in newborn infants.
Autor(a) principal: | |
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Data de Publicação: | 1997 |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2405 |
Resumo: | 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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Ethical decision-making in newborn infants.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.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.Ordem dos Médicos1997-03-30info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2405oai:ojs.www.actamedicaportuguesa.com:article/2405Acta Médica Portuguesa; Vol. 10 No. 2-3 (1997): Fevereiro-Março; 197-204Acta Médica Portuguesa; Vol. 10 N.º 2-3 (1997): Fevereiro-Março; 197-2041646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2405https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2405/1820Yu, V Yinfo:eu-repo/semantics/openAccess2022-12-20T11:00:30Zoai:ojs.www.actamedicaportuguesa.com:article/2405Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:17:43.756183Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Ethical decision-making in newborn infants. |
title |
Ethical decision-making in newborn infants. |
spellingShingle |
Ethical decision-making in newborn infants. Yu, V Y |
title_short |
Ethical decision-making in newborn infants. |
title_full |
Ethical decision-making in newborn infants. |
title_fullStr |
Ethical decision-making in newborn infants. |
title_full_unstemmed |
Ethical decision-making in newborn infants. |
title_sort |
Ethical decision-making in newborn infants. |
author |
Yu, V Y |
author_facet |
Yu, V Y |
author_role |
author |
dc.contributor.author.fl_str_mv |
Yu, V Y |
description |
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. |
publishDate |
1997 |
dc.date.none.fl_str_mv |
1997-03-30 |
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info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
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article |
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publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2405 oai:ojs.www.actamedicaportuguesa.com:article/2405 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2405 |
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oai:ojs.www.actamedicaportuguesa.com:article/2405 |
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por |
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por |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2405 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2405/1820 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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Ordem dos Médicos |
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Ordem dos Médicos |
dc.source.none.fl_str_mv |
Acta Médica Portuguesa; Vol. 10 No. 2-3 (1997): Fevereiro-Março; 197-204 Acta Médica Portuguesa; Vol. 10 N.º 2-3 (1997): Fevereiro-Março; 197-204 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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