Ethical issues in neonatal intensive care and physicians’ practices: A European perspective

2007 ◽  
Vol 95 ◽  
pp. 42-46 ◽  
Author(s):  
Marina Cuttini ◽  
Veronica Casotto ◽  
Marcello Orzalesi ◽  
Keyword(s):  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Ethical Issues ◽  
European Perspective

Ethical issues in neonatal intensive care and physicians’ practices: A European perspective

2006 ◽  
Vol 95 (0) ◽  
pp. 42-46 ◽  
Author(s):  
Marina Cuttini ◽  
Veronica Casotto ◽  
Marcello Orzalesi ◽  
THE EURONIC STUDY GROUP
Keyword(s):  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Ethical Issues ◽  
European Perspective

scholarly journals Ethical Issues around Death and Withdrawal of Life Support in Neonatal Intensive Care

2021 ◽  
Author(s):  
Stuti Pant
Keyword(s):  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Life Support ◽  
Ethical Issues ◽  
Ethical Dilemmas ◽  
Human Life ◽  
Traumatic Experiences ◽  
National Guidelines ◽  
Brain Injured ◽  
Discharge Against Medical Advice

AbstractAmongst all the traumatic experiences in a human life, death of child is considered the most painful, and has profound and lasting impact on the life of parents. The experience is even more complex when the death occurs within a neonatal intensive care unit, particularly in situations where there have been conflicts associated with decisions regarding the redirection of life-sustaining treatments. In the absence of national guidelines and legal backing, clinicians are faced with a dilemma of whether to prolong life-sustaining therapy even in the most brain-injured infants or allow a discharge against medical advice. Societal customs, vagaries, and lack of bereavement support further complicate the experience for parents belonging to lower socio-economic classes. The present review explores the ethical dilemmas around neonatal death faced by professionals in India, and suggests some ways forward.

Neonatal nurse practitioner ethics knowledge and attitudes

2018 ◽  
Vol 26 (7-8) ◽  
pp. 2247-2258
Author(s):  
Mobolaji Famuyide ◽  
Caroline Compretta ◽  
Melanie Ellis
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Nurse Practitioners ◽  
Neonatal Intensive Care ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Ethical Issues ◽  
Neonatal Nurse Practitioners

Background: Neonatal nurse practitioners have become the frontline staff exposed to a myriad of ethical issues that arise in the day-to-day environment of the neonatal intensive care unit. However, ethics competency at the time of graduation and after years of practice has not been described. Research aim: To examine the ethics knowledge base of neonatal nurse practitioners as this knowledge relates to decision making in the neonatal intensive care unit and to determine whether this knowledge is reflected in attitudes toward ethical dilemmas in the neonatal intensive care unit. Research design: This was a prospective cohort study that examined decision making at the threshold of viability, life-sustaining therapies for sick neonates, and a ranking of the five most impactful ethical issues. Participants and research context: All 47 neonatal nurse practitioners who had an active license in the State of Mississippi were contacted via e-mail. Surveys were completed online using Survey Monkey software. Ethical considerations: The study was approved by the University of Mississippi Medical Center Institutional Review Board (IRB; #2015-0189). Findings: Of the neonatal nurse practitioners who completed the survey, 87.5% stated that their religious practices affected their ethical decision making and 76% felt that decisions regarding life-sustaining treatment for a neonate should not involve consultation with the hospital’s legal team or risk management. Only 11% indicated that the consent process involved patient understanding of possible procedures. Participating in the continuation or escalation of care for infants at the threshold of viability was the top ethical issue encountered by neonatal nurse practitioners. Discussion: Our findings reflect deficiencies in the neonatal nurse practitioner knowledge base concerning ethical decision making, informed consent/permission, and the continuation/escalation of care. Conclusion: In addition to continuing education highlighting ethics concepts, exploring the influence of religion in making decisions and knowing the most prominent dilemmas faced by neonatal nurse practitioners in the neonatal intensive care unit may lead to insights into potential solutions.

How doctors communicated with parents in a neonatal intensive care: Communication and ethical issues

2020 ◽  
Vol 110 (1) ◽  
pp. 94-100
Author(s):  
Gaelle Sorin ◽  
Lionel Dany ◽  
Renaud Vialet ◽  
Laurent Thomachot ◽  
Sophie Hassid ◽  
...  
Keyword(s):  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Ethical Issues

Is Neonatal Medicine in the United States Out of Step?

PEDIATRICS ◽  
1993 ◽  
Vol 92 (4) ◽  
pp. 612-613
Author(s):  
WILLIAM A. SILVERMAN
Keyword(s):  
United States ◽  
Intensive Care ◽  
High Risk ◽  
Neonatal Intensive Care ◽  
Ethical Issues ◽  
The United States ◽  
Medical System ◽  
The World ◽  
Market Driven ◽  
Disproportionate Number

Here are the results of an informal survey which suggest that the number of neonatologists is disproportionately high in the United States: the ratio of neonatologists to liveborn infants may be two to six times higher than in six other countries examined (Table). The rough estimates raise some disturbing questions that can only be answered by formal surveys in each country which include the annual cost of neonatal intensive care (as percent of gross domestic product) and the compensation of neonatologists. In recent years, most of the discussion about the limits of neonatal intensive care has been focused on ethical issues. As costs of medical care have soared throughout the world, questions are now raised about the economic limits of this activity. For example, compared with the United States, has the rest of the world set more realistic financial limits on neonatal intensive care by controlling the number of neonatologists and their compensation? Is the relative surfeit of neonatologists explained by a disproportionate number of high-risk neonates in the United States, or is the number of practitioners market-driven in our laissez-faire medical system? These and other unsettling questions may be ignored, but they will not go away.

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