Unilateral Do-Not-Resuscitate Order in the Neonatal Intensive Care Unit

Paris, Julien; Singh, Jaideep; Schreiber, Michael D.; Reardon, Frank E.

doi:10.1038/sj.jp.7200196

Cited by 6 publications

(2 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In principle, treatment options should be discussed with parents. But, there is broad consensus that there is no moral obligation to offer treatments that are not medically indicated, cannot preserve life or whose burdens outweigh possible benefits, even if parents should ask for such treatment [5,10,13,22]. Failure of intensive care is a mainly medical finding [7].…”

Section: Discussionmentioning

confidence: 99%

Consultation of parents in actual end-of-life decision-making in neonates and infants

et al. 2006

View full text Add to dashboard Cite

The objective of this study was to assess how frequently end-of-life decisions (ELDs) with a possible or certain life-shortening effect in neonates and infants were discussed with parents, and to determine if consultation of parents was associated with the type of ELD, (clinical) characteristics of the patient, and socio-demographic characteristics of the physician. A retrospective study of all deaths of live born infants under the age of one year was conducted in Flanders, Belgium. For 292 of all 298 deaths in a 1-year period (between 1 August 1999 and 31 July 2000) the attending physician could be identified and was sent an anonymous questionnaire. All cases with an ELD and containing information regarding the consultation of parents were included. The response rate was 87% (253/292). In 136 out of 143 cases, an ELD was made and information on the consultation of parents was obtained. According to the physician, the ELD was discussed with parents in 84% (114/136) of cases. The smaller the gestational age of the infant, the more the parental request for an ELD was explicit (p=0.025). When parents were not consulted, the ELD was based more frequently on the fact that the infant had no chance to survive and less on quality-of-life considerations (p=0.001); the estimated shortening of life due to the ELD was small in all cases, but significantly smaller (p<0.001) if parents were not consulted. It is concluded that the majority of parents of children dying under the age of one year are consulted in ELD-making, especially for decisions based on quality-of-life considerations (95.1%). Parents of infants with a small gestational age more often explicitly requested an ELD.

show abstract

Section: Discussionmentioning

confidence: 99%

Consultation of parents in actual end-of-life decision-making in neonates and infants

et al. 2006

View full text Add to dashboard Cite

show abstract

“…4 Several high profile ethical cases have centered around clinicians' decisions not to pursue futile medical care despite parental insistence. 5 This stance has been explicitly supported by British judges. 6 One of the purposes of our articles was to illustrate that there is extraordinarily little evidence available about outcomes or costs.…”

Section: Hugh Macdonald MD Pediatric Critical Care Medical Groupmentioning

confidence: 99%