[Withholding treatment in terminally-ill newborns with Islamic parents]

Area of Science:

• Neonatal medicine
• Bioethics
• Pediatric critical care

Background:

• End-of-life decisions for critically ill newborns involve parents and physicians.
• Disagreements can arise regarding the infant's best interest, parental autonomy, and physician's duty to prevent suffering.
• Religious beliefs, such as those in Islam, can influence parental consent for end-of-life interventions.

Observation:

• Three cases of terminally ill newborn girls with skeletal dysplasia, bronchopulmonary dysplasia, necrotizing enterocolitis complications, and trisomy 18 are presented.
• In two cases, lack of consensus between parents and physicians led to prolonged infant suffering.
• Islamic parents prioritize divine will and human dignity, potentially conflicting with medical recommendations for life-sustaining treatment withdrawal.

Findings:

• Physicians may face ethical dilemmas balancing parental autonomy with the infant's well-being and avoiding suffering.
• Cultural and religious differences significantly impact end-of-life decision-making processes in neonatal care.
• Effective communication and respect for diverse beliefs are essential to mitigate conflicts.

Implications:

• Healthcare providers must be sensitive to diverse cultural and religious beliefs when discussing end-of-life care for neonates.
• Proactive communication strategies are needed to build consensus and prevent ethically challenging situations.
• Prioritizing the infant's best interest, within a framework of mutual respect, is paramount in neonatal palliative care.