The attitudes of neonatal professionals towards end-of-life decision-making for dying infants in Taiwan

Journal of Medical Ethics 39 (6):382-386 (2013)

Authors
H. C. B. Liu
University of California, Berkeley
Abstract
The purposes of research were to describe the neonatal clinicians' personal views and attitudes on neonatal ethical decision-making, to identify factors that might affect these attitudes and to compare the attitudes between neonatal physicians and neonatal nurses in Taiwan. Research was a cross-sectional design and a questionnaire was used to reach different research purposes. A convenient sample was used to recruit 24 physicians and 80 neonatal nurses from four neonatal intensive care units in Taiwan. Most participants agreed with suggesting a do not resuscitate (DNR) order to parents for dying neonates (86.5%). However, the majority agreed with talking to patients about DNR orders is difficult (76.9%). Most participants agree that review by the clinical ethics committee is needed before the recommendation of ‘DNR’ to parents (94.23%) and nurses were significantly more likely than physicians to agree to this (p=0.043). During the end-of-life care, most clinicians accepted to continue current treatment without adding others (70%) and withholding of emergency treatments (75%); however, active euthanasia, the administration of drug to end-of-life, was not considered acceptable by both physicians and nurses in this research (96%). Based on our research results, providing continuing educational training and a formal consulting service in moral courage for neonatal clinicians are needed. In Taiwan, neonatal physicians and nurses hold similar values and attitudes towards end-of-life decisions for neonates. In order to improve the clinicians' communication skills with parents about DNR options and to change clinicians' attitudes for providing enough pain-relief medicine to dying neonates, providing continuing educational training and a formal consulting service in moral courage are needed
Keywords info:mesh/Self Report  info:mesh/Attitude of Health Personnel  Humans   Resuscitation Orders   Terminal Care   Withholding Treatment   Questionnaires   Cross-Sectional Studies   Attitude of Health Personnel   Attitude to Death   Decision Making   Neonatology   Education, Medical, Continuing   Ethics Committees, Clinical   Adult   Middle Aged   Infant, Newborn   Medical Staff, Hospital   Nursing Staff, Hospital   Intensive Care Units, Neonatal   Referral and Consultation   Taiwan   Female   Male   Self Report  info:mesh/Middle Aged  info:mesh/Decision Making  info:mesh/Withholding Treatment  info:mesh/Nursing Staff, Hospital  info:mesh/Neonatology  info:mesh/Attitude to Death  info:mesh/Humans  info:mesh/Referral and Consultation  info:mesh/Medical Staff, Hospital  info:mesh/Adult  info:mesh/Taiwan  info:mesh/Intensive Care Units, Neonatal  info:mesh/Ethics Committees, Clinical  info:mesh/Terminal Care  info:mesh/Cross-Sectional Studies  info:mesh/Resuscitation Orders  info:mesh/Questionnaires  info:mesh/Male  info:mesh/Female  i
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DOI 10.1136/medethics-2011-100428
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Three Myths in End-of-Life Care.Dominic Wilkinson - 2013 - Journal of Medical Ethics 39 (6):389-390.

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