Matters of Life and Death in the Neonatal Intensive Care Unit: Decision-Making for the Not-yet-Competent

Dissertation, The University of British Columbia (Canada) (2004)
Neonatology is a branch of paediatrics dealing with extremely ill or premature babies, and the neonatal intensive care unit is frequently the setting for life-and-death decisions. Society considers parents to be the proper persons to make those decisions for their babies, but in practice they seem to be allowed to do this only as long as they agree with medical recommendations; otherwise, the "best interest standard" is proposed. My objective is to evaluate decision-making in the NICU. Part I of this research, a descriptive study, compares decision-making by parents, doctors, and nurses when presented with hypothetical scenarios. Part II, through in-depth interviews, evaluates factors important to parents in making life-and-death decisions. Part III, using structured interviews, explores the neonatologists' perceptions of the limits of parental decision-making authority. ;The results reveal that parents make different decisions from those of doctors and nurses. Parents have an equal commitment to intensive care with either mental or physical handicap. Doctors and nurses, on the other hand, have less commitment to intensive care with severe mental handicap , but more commitment with physical handicap . Religious commitment and experience with handicap influence decisions by parents, but not by doctors and nurses. The right of parents to decide for their baby and the interests of the family are also more important for parents than for doctors and nurses. For parents, furthermore, the important factors are an honest, caring, transparent relationship with good communication with their neonatologist; being fully informed; their values and beliefs; their roles and their sense of loss of control; and emotional turmoil. Of these interrelated factors, the most important is the relationship between parents and doctors. For parents, quality of life considerations are individual. For all study participants, the interests of the baby are most important. According to neonatologists, parents are the appropriate decision-makers, but within limits. It is concluded that not only do parents make different decisions from those of doctors and nurses, but that several concerns in the decision-making process in our NICU require urgent attention
Keywords No keywords specified (fix it)
Categories (categorize this paper)
 Save to my reading list
Follow the author(s)
Edit this record
My bibliography
Export citation
Find it on Scholar
Mark as duplicate
Request removal from index
Revision history
Download options
Our Archive

Upload a copy of this paper     Check publisher's policy     Papers currently archived: 31,812
External links

Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
Through your library
References found in this work BETA

No references found.

Add more references

Citations of this work BETA

No citations found.

Add more citations

Similar books and articles
Added to PP index

Total downloads

Recent downloads (6 months)

How can I increase my downloads?

Monthly downloads

Sorry, there are not enough data points to plot this chart.
My notes
Sign in to use this feature