Decision-Making in the Delivery Room  

Oleh:

Mercurio, Mark R .

Jenis: Article from Books - E-Book
Dalam koleksi: Clinical Ethics in Pediatrics A Case-Based Textbook, page 77-82.
Topik: Decision-making; Ethical principles; Delivery Room
Fulltext: Decision-Making in the Delivery Room.pdf (119.83KB)

Isi artikel

Decisions regarding newborn resuscitation are ot en made under great time pressure, either due to imminent delivery, thus limiting the time for discussion with the parents beforehand, or because specificactions may be required immediately at er delivery if the child is to have a chance at survival. For this reason, it is essential to have considered the possible scenarios that may arise when the child is born and, as much as possible, to have worked through the ethical questions beforehand. There will be very little, if any, opportunity for ethical analysis or in-depth discussion at the time of delivery. Difficult ethical and medical decisions made in the setting of the delivery room (DR) and newborn intensive care unit (NICU) ot en involve extreme pre- maturity or “borderline viability,” and for that reason this case has been chosen for discussion. However, the ethical questions relevant to this case will be equally relevant to the management of any newborn for whom prognosis regarding survival and/or permanent disability is signii cantly worse than for a normal healthy infant. Such questions include: Is the prognosis poor enough to justify a decision not to attempt resuscitation? What should prospective parents be told by the pediatric team prior to delivery? How much control should the parents have with regard to medical management? What options should they be given with regard to resuscitation and newborn care? The ethical questions faced in the management of an infant in the DR can perhaps best be summarized as follows: Which among the possible resuscitation options would be ethically impermissible, permissible, or obligatory, and how should that be determined?

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