The demands and limits of care???ethical reflections on the moral dilemma of neonatal intensive care

Initiating technology dependence to sustain a child’s life: a systematic review of reasons

“…Clinical decision 11 ; Clinical need 8 11 13 21 28 45 ; Clinical judgement 12 47 ; End-of-life care 48 ; Following guidelines 49 ; Guidelines 17 ; Intensive treatment 48 ; Judgement of futility 14 ; Prognosis 16 21 24 42 ; Prognostication 22 ; Requirement to make a decision 14 ; Treatment 8 27 29 34 ; Treatment decision 26 Quality of life 50 ; Unconsciousness of patient 43 ; Well-being 28 Communication 15 24 42 51 ; Corporate policy 49 ; Decision-making 30 ; Disputes and obstacles to good care 44 ; Duty 12 52 ; Ethics 12 29 Fear 43 ; Interpretation of policy 49 ; Information provision 26 39 ; Legal influence 47 ; Medical principle 24 ; Moral dilemmas 21 ; Obligation to relieve suffering 19 ; Obligation 53 ; Purpose of role 19 ; Responsibility 23 24 28 35 47 52 ; Widespread belief 52 Being familiar with patient or ward 13 ; Compassion 19 ; Cultural influences 49 ; Distress 44 ; Emotions 35 ; Experience maturity 15 35 ; Professional experience 13 ; Professional objectivity 35 ; Religion 13 ; Values 16 52…”

Handbook of Intellectual and Developmental Disabilities

“…Even if there are no questions about presenting the prenatal diagnosis, there are many questions surrounding how the diagnosis should be presented and, particularly, what kinds of discussions to hold with the expectant mother and, possibly, father regarding the seriousness of the diagnosis, prognosis, and, if any, available treatments. Most of the issues are covered in the literature in a general way (Hauerwas, 1975;Hemphill & Freeman, 1977;Reich, 1987). It is generally recognized that recent advances in neonatal care have greatly increased the likelihood of survival of infants with serious medical conditions (Hauerwas, 1975), but this increased probability of survival comes at a large increase in cost at the neonatal intensive care unit and possible later medical costs throughout childhood and, perhaps, the life of the individual (Reynolds, 1978).…”

“…Most of the issues are covered in the literature in a general way (Hauerwas, 1975;Hemphill & Freeman, 1977;Reich, 1987). It is generally recognized that recent advances in neonatal care have greatly increased the likelihood of survival of infants with serious medical conditions (Hauerwas, 1975), but this increased probability of survival comes at a large increase in cost at the neonatal intensive care unit and possible later medical costs throughout childhood and, perhaps, the life of the individual (Reynolds, 1978). Is there a limit to providing high technology neonatal care considering predictable massive future medical costs?…”

Chapter 6. Must a Patient Be a Person to Be a Patient?

“…In the same manner, we do not care or cease to care for a child born defective because it is or is not a person. Rather, whether or how we decide to care for such a child depends on our attitude toward the having and caring for children, our perception of our role as parents, and how medicine is seen as one form of how care is to be given to children (Hauerwas 1975). (For it may well be that we will care for such children, but this does not mean that medicine has some kind of overriding claim on being the form that such care should take.…”