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[Ethical dilemmas in the perinatal period: guidelines for end-of-life decisions]
1Service de pédiatrie et réanimation néonatales, hôpital Antoine-Béclère, 157, rue de la Porte-de-Trivaux, 92141 Clamart, France. michel.dehan@abc.ap-hop-paris.fr
Insights
French neonatal intensive care units (NICUs) report that approximately 50% of deaths stem from medical decisions. This paper outlines new guidelines for end-of-life care in the perinatal period, addressing ethical considerations and clinical practices.
Area of Science:
- Neonatal Medicine
- Medical Ethics
- Perinatal Care
Context:
- Recent surveys indicate that around 50% of deaths in French neonatal intensive care units (NICUs) are a result of medical decisions.
- This highlights a significant ethical and clinical challenge in perinatal care.
Purpose:
- To present newly established guidelines for end-of-life decisions and practices in the perinatal period.
- To provide a framework for neonatologists and healthcare professionals in managing complex end-of-life situations.
Summary:
- The guidelines cover essential definitions, various clinical scenarios, and core ethical principles relevant to neonatal end-of-life care.
- They also detail the obligations of medical and nursing staff and address specific conditions that may lead to ethical dilemmas.
- The focus is on structured decision-making in critical neonatal care.
Impact:
- Aims to standardize and improve the quality of end-of-life care in French NICUs.
- Provides a resource for healthcare professionals to navigate ethically challenging situations with greater clarity and consistency.
- Contributes to a more humane and ethically sound approach to neonatal mortality in intensive care settings.
Abstract:
According to several recent surveys, around 50% of the deaths occurring nowadays in French neonatal intensive care units result from a medical decision. This has led French neonatologists to set up guidelines for end-of-life decisions and practice in the perinatal period, which are presented in this paper. It covers definitions, clinical situations, ethical principles, obligations of the medical and nursing staff, and specific conditions where dilemmas occur.