Parental rights at the birth of a near-viable infant: Conflicting perspectives

Problèmes éthiques posés par l'extrême prématurité: résultats d'une étude qualitative auprès des obstétriciens et des sages-femmes

“…Ils ne souhaitaient pas leur faire porter le poids de la décision considérant qu'ils n'étaient pas capables ou pas en état de comprendre les aspects médicaux de la santé de leur enfant et, qu'à plus long terme, ils risquaient d'éprouver des sentiments de culpabilité. Pourtant, des publications émanant d'autres pays avaient décrit des pratiques impliquant les parents et insisté sur la nécessité de les faire participer au processus décisionnel [36][37][38]. Dans les recommandations publiées en 2000 par la Fédération française des pédiatres néonatologistes, on trouve un plaidoyer en faveur d'une plus grande implication des parents et d'un « climat de confiance pour cheminer avec les parents, mais sans placer sur eux la responsabilité de la décision » [18].…”

Decision-making in the delivery room: a survey of neonatologists

“…22 Recognition of the subjectivity and uncertainty inherent in physician decisions about infant resuscitation and the authority of parents suggests that parents have a right to informed refusal of resuscitation if they believe the refusal represents the infant's best interests. 23 However, even when neonatologists know parents' resuscitation preferences, the benefit of resuscitation in the delivery room perceived by the neonatologist may render the parents' wishes of secondary importance. 24 Getting parents involved in resuscitation decisions Despite a historic shift in biomedical ethics toward a model of shared physician and patient or parent decisional authority, neonatologists may not always involve parents, as evidenced by less parental involvement by those choosing a younger gestation age for obligatory resuscitation.…”

“…In a 1997 article, Pinkerton et al 23 stated that neonatologists favor the ethical tenet of 'physicians ought to opt for life.' The application of this tenet could result in more and earlier resuscitations, which could be abetted by both the 2002 Born-Alive Infants Protection Act and a misunderstanding of the Baby Doe guidelines as enforcing resuscitation for all regardless of circumstance.…”

Decisional Challenges for Children Requiring Assisted Ventilation at Home

“…This should not be surprising since, under ordinary circumstances, who could make better decisions for children than their parents? No one else is as familiar with their needs or as likely to cherish them (Nolan, 1987;Pinkerton, 1997). Parents also will have what John Lantos calls the "individual instincts of conscience" most likely to translate into the morally appropriate choice (2001).…”

“…Shared decision making between parents and physicians is viewed by many as the ideal strategy for promoting the best possible choices under difficult circumstances (Canadian Peadiatric Society, 2004; American Academy of Pediatrics, 1995;1996;Danish Council of Ethics, 1995;Pinkerton, 1997). Parents depend on health care professionals to share their expertise and make recommendations concerning the best possible course of action for their children.…”