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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
International perspectives on treatment choice in neonatal intensive care units
1Department of Health and Nutrition Sciences, Brooklyn College, NY 11210.
Insights
Neonatal intensive care units (NICUs) offer advanced treatments for critically ill newborns. This study examines bioethical decision-making factors for disabled infants globally, comparing US practices with other nations.
Area of Science:
- Neonatal care
- Bioethics
- Comparative health policy
Background:
- Neonatal intensive care units (NICUs) have expanded globally over 25 years.
- Treatment decisions for newborns with disabilities involve complex factors.
- Limited comparative research exists on international bioethical practices in NICUs.
Purpose of the Study:
- To provide an international perspective on bioethical issues in neonatal care.
- To compare US bioethical practices with those in other nations.
- To highlight the need for further comparative research in this field.
Main Methods:
- Review of bioethical issues in neonatal care.
- Comparative analysis of US practices versus generalized international practices.
- Survey of practices in Australia, Brazil, Britain, Canada, China, France, India, Israel, Japan, the Netherlands, Poland, Sweden, and West Germany.
Main Results:
- Four key factors influence treatment choices: resource availability, societal attitudes, decision-maker roles, and legal frameworks.
- US bioethical practices have received significant attention, unlike those in many other nations.
- International variations in addressing bioethical dilemmas in neonatal care exist.
Conclusions:
- Understanding international perspectives on neonatal bioethics is crucial.
- Comparative research is essential to inform global best practices in NICU care.
- Further research should explore and compare global approaches to ethical decision-making for newborns at risk.
Abstract:
Over the past 25 years, neonatal intensive care units (NICUs) have been established throughout the industrialized world and in some Third World nations to provide sophisticated medical interventions for critically ill newborns. This paper discusses the four major factors affecting treatment choices for newborns with disabilities or at risk for disabilities: the availability of resources, societal attitudes toward medical interventions and life with disabilities, the roles of physicians, parents and other decision-makers, and the role of the law. Much has been written on the bioethical issues surrounding such treatment as it is practiced in the United States, including analysis by social scientists; however, little has been written on how those issues are perceived and dealt with in most other nations, and very little comparative research has been conducted. The author provides an international perspective on the bioethical issues involved by comparing U.S. practice, which has received much attention, with a generalized commentary on practices in other parts of the world, which have received less examination. The nations surveyed include Australia, Brazil, Britain, Canada, China, France, India, Israel, Japan, the Netherlands, Poland, Sweden, and West Germany. The value of further comparative research is discussed in order to encourage others to do such research.
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