The offer they can't refuse: parents and perinatal treatment decisions

Area of Science:

• Neonatal Medicine
• Bioethics
• Perinatal Care

Background:

• Parental autonomy in neonatal decision-making is often limited by insufficient information.
• Hospitals and neonatologists may have incentives favoring intensive treatment over parental wishes.
• The intensive care environment can be intimidating for parents.

Purpose of the Study:

• To examine the barriers to informed parental decision-making for extremely preterm neonates.
• To explore the potential of prenatal advance directives to improve parental choice.
• To advocate for greater transparency in neonatal care.

Main Methods:

• Review of current practices in neonatal intensive care.
• Analysis of ethical considerations in preterm infant treatment decisions.
• Proposal of prenatal advance directives as a tool for informed consent.

Main Results:

• Families frequently lack comprehensive information on preterm birth consequences and treatment options.
• Professional and financial incentives can override parental preferences.
• Prenatal directives offer a structured approach to delivering information and respecting parental values.

Conclusions:

• Prenatal advance directives can enhance informed parental choice for extremely preterm neonates.
• Increased transparency in obstetric and neonatal care is crucial.
• Empowering parents with information supports ethical decision-making and respects family autonomy.