Ethics ain't easy: Do we need simple rules for complicated ethical decisions?

Acta Paediatrica, International Journal of Paediatrics

Volumn 97, Issue 4, 2008, Pages 402-406

  Janvier, Annie ^a   Barrington, Keith J ^b,f   Aziz, Khalid ^c   Lantos, John ^d,e  

^a MCGILL UNIVERSITY   (Canada)

^b ROYAL VICTORIA HOSPITAL   (Canada)

^c UNIVERSITY OF ALBERTA   (Canada)

^d UNIVERSITY OF CHICAGO   (United States)

^e Center for Practical Bioethics   (United States)

^f MCGILL UNIVERSITY HEALTH CENTRE   (Canada)

Author keywords

Advocacy; Autonomy; Decision making; Ethics; Extreme preterm; Extremely low birth weight; Outcomes; Policies; Preterm delivery; Recommendations; Withdrawal of life support

Indexed keywords

STEROID;

ADULT; BIRTH WEIGHT; CASE REPORT; CLINICAL DECISION MAKING; CLINICAL FEATURE; CLINICAL PRACTICE; DRUG USE; FEMALE; GESTATIONAL AGE; HEALTH CARE POLICY; HEALTH PERSONNEL ATTITUDE; HUMAN; INFANT; MEDICAL ASSESSMENT; MEDICAL ETHICS; NEWBORN CARE; PREMATURITY; PRESCHOOL CHILD; PRIORITY JOURNAL; PROGNOSIS; REVIEW; SEX DIFFERENCE;

CARDIOPULMONARY RESUSCITATION; DECISION MAKING; GESTATIONAL AGE; HUMANS; INFANT, NEWBORN; INFANT, PREMATURE; RESUSCITATION ORDERS; WITHHOLDING TREATMENT;

EID: 41149135300     PISSN: 08035253     EISSN: 16512227     Source Type: Journal    
DOI: 10.1111/j.1651-2227.2008.00752.x     Document Type: Review

References (24)

1. Mc Donald H, for the committee on Fetus and Newborn (COFN) of the AAP. Perinatal care at the threshold of viability. Pediatrics 2002 110 : 1024 7.
2. NRP Steering Committee. Textbook of neonatal resuscitation, 4th ed. American Academy of Pediatrics 2006 Elk Grove Village, IL, USA, pp : 7.18.
3. Rashid A, Khanna A, Gowar JP, Bull JP. Revised estimates of mortality from burns in the last 20 years at the Birmingham Burns Centre. Burns 2001 27 : 723 30.
4. Spies M, Herndon DN, Rosenblatt JI, Sanford AP, Wolf SE. Prediction of mortality from catastrophic burns in children. Lancet 2003 361 : 989 94.
5. Fetus and Newborn Committee, Canadian Paediatric Society. Management of the woman with threatened birth of an infant of extremely low gestational age. Can Med Assoc J 1994 151 : 547 51.
6. Nuffield Council on Bioethics. Critical care decisions in fetal and neonatal medicine: ethical issues. England, United Kingdom. Available at : http://www.neonet.ch/assets/doc/Infants_born_at_the_limit_of_ viability_-_english_final.pdf http://www.nuffieldbioethics.org/go/ourwork/ neonatal/publication_406.html accessed March 3, 2008 at : http://www.neonet.ch/assets/ doc/Infants_born_at_the_limit_of_viability_-_english_final.pdf. Accessed April 3, 2007.
7. Salle B, Sureau C. Le préma de moins de 28 SA, sa réanimation et son avenir. Rapport de l'académie de médecine, 2006, saisie dans sa séance du mardi 20 juin 2006. Available at : http://www.academie-medecine.fr/upload/base// rapports_289_fichier_lie.rtf. Accessed April 3, 2007.
8. Verloove-Vanhorick S. Management of the neonate at the limits of viability: the Dutch viewpoint. BJOG 2006 113 (Suppl. 3 13 6.
9. The International Liaison Committee on Resuscitation (ILCOR). Consensus on science with treatment recommendations for pediatric and neonatal patients: neonatal resuscitation. Pediatrics 2006 117 : e978 88.
10. Hopson LR, Hirsh E, Delgado J, Domeier RM, McSwain JNE, Krohmer J. Guidelines for withholding or termination of resuscitation in prehospital traumatic cardiopulmonary arrest: joint position statement of the National Association of EMS Physicians and the American College of Surgeons Committee on Trauma. J Am Coll Surg 2003 196 : 106 12.
11. Janvier A, Bauer KL, Lantos JD. Are newborns morally different from older children? Thoer Med Bioeth 2007 28 : 413 25.
12. Calkins CM, Bensard DD, Partrick DA, Karrer FM. A critical analysis of outcome for children sustaining cardiac arrest after blunt trauma. J Pediatr Surg 2002 37 : 180 4.
13. Wijdicks EFM, Hijdra A, Young GB, Bassetti CL, Wiebe S. Practice parameter: prediction of outcome in comatose survivors after cardiopulmonary resuscitation (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2006 67 : 203 10.
14. Fogelholm R, Murros K, Rissanen A, Avikainen S. Long term survival after primary intracerebral haemorrhage: a retrospective population based study. J Neurol Neurosurg Psychiatry 2005 76 : 1534 8.
15. Sladkevicius P, Saltvedt S, Almstrom H, Kublickas M, Grunewald C, Valentin L. Ultrasound dating at 12-14 weeks of gestation. A prospective cross-validation of established dating formulae in in-vitro fertilized pregnancies. Ultrasound Obstet Gynecol 2005 26 : 504 11.
16. Wennerholm UB, Bergh C, Hagberg H, Sultan B, Wennergren M. Gestational age in pregnancies after in vitro fertilization: comparison between ultrasound measurement and actual age. Ultrasound Obstet Gynecol 1998 12 : 170 4.
17. Doyle LW, for the Victorian Infant Collaborative Study Group. Outcome at 5 years of age of children 23 to 27 weeks' gestation: refining the prognosis. Pediatrics 2001 108 : 134 41.
18. BBC News online news item. 'Early babies dubbed bed blockers'. Available at : http://news.bbc.co.uk/2/hi/health/4848698.stm accessed March 3, 2008 GJ. Extremely preterm birth and parental authority to refuse treatment - the case of Sidney Miller. N Engl J Med 2004 351 : 2118 23.
19. Singh J, Fanaroff J, Andrews B, Caldarelli L, Lagatta J, Plesha-Troyke S, et al. Resuscitation in the 'gray zone' of viability: determining physician preferences and predicting infant outcomes. Pediatrics 2007 120 : 519 26.
20. Finer NN, Tarin T, Vaucher YE, Barrington K, Bejar R. Intact survival in extremely low birth weight infants after delivery room resuscitation. Pediatrics 1999 104 : e40.
21. Mercurio MR. Physician's refusal to resuscitate at borderline gestational age. J Perinatol 2005 25 : 685 9.
22. Lorenz JM. Prenatal counseling and resuscitation decisions at extremely premature gestation. J Pediatr 2005 147 : 567 8.
23. Hefferman P, Heilig S. Giving 'moral distress' a voice: ethical concerns among neonatal intensive care unit personnel. Camb Q Healthc Ethics 1999 8 : 173 8.
24. Janvier A, Leblanc I, Barrington K. The best interest standard is not used for neonatal resuscitation decisions. Pediatrics 2008 in press).