Theoretical Medicine and Bioethics 28 (5):393-412 (2007)
There is a broadly held view that neonatologists are ethically obligated to act to override parental nontreatment decisions for imperiled premature newborns when there is a reasonable chance of a good outcome. It is argued here that three types of uncertainty undercut any such general obligation: (1) the vagueness of the boundary at which an infant’s deficits become so intolerable that death could be reasonably preferred; (2) the uncertainty about whether aggressive treatment will result in the survival of a reasonably healthy child or, alternatively, the survival of a child with intolerable deficits; and (3) the inability to determine an acceptable ratio between the likelihoods of those two outcomes. It is argued that the broadly held view accords insufficient weight to the fact that newborn intensive care increases the likelihood of harm to the child by effecting survival with intolerable deficits. Though treatment may offer a reasonable chance of a good outcome, it is argued that there are situations in which neonatologists should nonetheless defer to parental nontreatment decisions.
|Keywords||neonatology NICU ethics newborns ELBW death parental authority pediatrics|
|Categories||categorize this paper)|
References found in this work BETA
Ethics at the Edges of Life: Medical and Legal Intersections.Paul Ramsey - 1978 - Yale University Press.
Treating Baby Doe: The Ethics of Uncertainty.Nancy K. Rhoden - 1986 - Hastings Center Report 16 (4):34-42.
Profoundly Diminished Life: The Casualties of Coercion.E. Haavi Morreim - 1994 - Hastings Center Report 24 (1):33-42.
Mongolism, Parental Desires, and the Right to Life.James M. Gustafson - 1973 - Perspectives in Biology and Medicine 16 (4):529-557.
The Groningen Protocol - Euthanasia in Severely Ill Newborns.E. Verhagen & P. J. J. Sauer - 2005 - New England Journal of Medicine 352 (10):959-962.
Citations of this work BETA
A Life Worth Giving? The Threshold for Permissible Withdrawal of Life Support From Disabled Newborn Infants.Dominic James Wilkinson - 2011 - American Journal of Bioethics 11 (2):20 - 32.
Conflicts Between Parents and Health Professionals About a Child’s Medical Treatment: Using Clinical Ethics Records to Find Gaps in the Bioethics Literature.Rosalind McDougall, Lauren Notini & Jessica Phillips - 2015 - Journal of Bioethical Inquiry 12 (3):429-436.
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