Les prises de décisions éthiques en réanimation néonatale. Enquête auprès des soignants de deux centres français

Garel, M.; Gosme-Séguret, S; Kaminski, Monique; Cuttini, Marina

doi:10.1016/s0929-693x(97)83370-2

Cited by 26 publications

(12 citation statements)

References 34 publications

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“…In-depth interviews, carried out as part of this same project in two French units, provide insights into staff beliefs and values which underlie this policy38: perceived altered psychological status of parents because of the baby’s illness, their lack of medical knowledge, and most of all a desire to spare them the burden of such difficult choices and protect them from the feelings of guilt for having wanted and decided the death of their child.…”

Section: Discussionmentioning

confidence: 99%

Parental visiting, communication, and participation in ethical decisions: a comparison of neonatal unit policies in Europe

Cuttini

Rebagliato

Bortoli

et al. 1999

Archives of Disease in Childhood - Fetal and Neonatal Edition

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116

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Aim-To compare neonatal intensive care unit policies towards parents' visiting, information, and participation in ethical decisions across eight European countries. Methods-One hundred and twenty three units, selected by random or exhaustive sampling, were recruited, with an overall response rate of 87%. Results-Proportions of units allowing unrestricted parental visiting ranged from 11% in Spain to 100% in Great Britain, Luxembourg and Sweden, and those explicitly involving parents in decisions from 19% in Italy to 89% in Great Britain. Policies concerning information also varied. Conclusions-These variations cannot be explained by diVerences in unit characteristics, such as level, size, and availability of resources. As the importance of parental participation in the care of their babies is increasingly being recognised, these findings have implications for neonatal intensive care organisation and policy. (Arch Dis Child Fetal Neonatal Ed 1999;81:F84-F91)

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Section: Discussionmentioning

confidence: 99%

Parental visiting, communication, and participation in ethical decisions: a comparison of neonatal unit policies in Europe

Cuttini

Rebagliato

Bortoli

et al. 1999

Archives of Disease in Childhood - Fetal and Neonatal Edition

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116

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“…The content of the original statements which we adapted for our research was decided on the basis of the international literature and in-depth qualitative interviews among healthcare professions in different countries [9,21,28]. It was further evaluated by a team of experts of different scientific and cultural backgrounds [9][10][11]13,29,30].…”

Section: Questionnairesmentioning

confidence: 99%

Ethical issues in NICUs: The Attitude of Greek Healthcare Professionals Towards the Value of Human Life

Δάγλα¹,

Petousi²,

Πούλιος³

2017

Health Care Current Reviews

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Objective: This paper presents the first Greek empirical research on bioethical neonatal issues. The study goals were: 1) to document and measure the attitude of Greek healthcare professionals' working in NICUs towards the value of human life (intrinsic value vs. quality of life) as ethical decision making guiding principle in the provision of intensive treatment to extremely/very preterm babies and 2) to investigate the socio-cultural and other parameters which form this attitude. Methods:Questionnaires developed for the EURONIC project and implemented in research in 11 countries were culturally adjusted to the Greek NICU context. Healthcare professionals (n=495) who were employed in Greek NICUs (May 2009-May 2011 and met inclusion criteria were invited to participate. Of those 251 (98 midwives, 82 nurses and 71 doctors) completed a structured, self-administered, anonymous questionnaire (response rate 50.7%). Results:The reported attitude score (total sample mean attitude score=3.09) indicates that Greek healthcare professionals tend to support the intrinsic value of human life position. Gender (p<0.05), the importance placed on religion (p<0.05) and profession specialization (p<0.01) were found to influence their attitude in statistically significant ways. Specifically, men, professionals who consider religion as being important in their life and midwives and nurses tend to be more supportive of the intrinsic value of life position. NICUs' equipment and personnel, the cost of neonatal healthcare provision, and the burden of disability on the neonate's family have not been found to influence healthcare professionals' attitude in statistically significant ways. Conclusion:Compared to the findings from other countries in which the EURONIC research was implemented, Greek healthcare professionals appear to hold a rather vitalistic approach and follow the intrinsic value of human life position as their ethical decision-making guiding principle. Socio-cultural and professional characteristics explain ethical decision making differences among healthcare professionals.

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“…At best parents receive, together with relevant medical facts, the neonatologist's assessment of whether intensive or palliative care is indicated, and are asked for their 'informed consent', a process which has been described by Anspach [35] as 'producing assent' rather than real sharing of responsibility for decision-making. In some countries and NICUs the whole process takes place implicitly and parents are informed simply about the consequences of decision-making rather than about its occurrence and contents [36,37] .…”

Section: The Role Of Parentsmentioning

confidence: 99%

“…The parents should never be left alone with the burden of decision-making [40] ; however, the argument should not be used as a reason for restricting the information given to them and undermining their role as decisionmakers [36,37] . The available research does not support the idea that participating in decisions is harmful to parents; rather, those who played a more active role report less subsequent problems such as anger, depression, sleeping diffi culties, loss of appetite and wanting to be left alone [41,42] .…”

Section: The Role Of Parentsmentioning

confidence: 99%

Ethical Considerations in Neonatal Respiratory Care

Orzalesi

Cuttini²

2005

Neonatology

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Recent advances in neonatal care have greatly improved the chances for survival of very sick and/or very preterm neonates and have in fact changed the concept and the limits of viability. However, in some situations, when the infant’s demise can only be postponed at the price of great suffering or when survival is associated with severe disabilities and an intolerable life for the patient and the parents, it may be unwise to employ the full armamentarium of modern neonatal intensive care. In those circumstances withholding or withdrawing mechanical ventilation and other life-saving, though invasive and painful, procedures might be a better option. This review examines the ethical principles underlying those difficult decisions, the most frequent circumstances where they should be considered, the role of parents and other parties in the decision-making process and the reported behavior of neonatologists in many American and European neonatal intensive care units.

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Les prises de décisions éthiques en réanimation néonatale. Enquête auprès des soignants de deux centres français

Cited by 26 publications

References 34 publications

Parental visiting, communication, and participation in ethical decisions: a comparison of neonatal unit policies in Europe

Parental visiting, communication, and participation in ethical decisions: a comparison of neonatal unit policies in Europe

Ethical issues in NICUs: The Attitude of Greek Healthcare Professionals Towards the Value of Human Life

Ethical Considerations in Neonatal Respiratory Care

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