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Withholding or withdrawal of life sustaining treatment for newborn infants

Narendra Aladangady1, Laura de Rooy

  • 1Neonatal Unit, Homerton University Hospital NHS Foundation Trust, Homerton Row, London, UK. Narendra.aladangady@homerton.nhs.uk

Early Human Development
|January 21, 2012
PubMed

Insights

With advances in perinatal medicine, withholding or withdrawing life-sustaining treatment may be best for some extremely preterm or sick newborns. This overview guides these difficult decisions, emphasizing palliative care.

Area of Science:

  • Neonatal Medicine
  • Perinatal Care
  • Bioethics

Background:

  • Significant improvements in survival rates for extremely preterm and sick newborns over the past two decades.
  • Despite advances, withholding or withdrawal of life-sustaining treatment remains a consideration for some infants.
  • Ethical and clinical challenges in end-of-life care for critically ill neonates.

Purpose of the Study:

  • To provide an overview of considerations for withholding or withdrawing life-sustaining treatment in neonates.
  • To describe the decision-making process, including factors influencing parental choices and conflict resolution.
  • To outline which treatments may be withheld or withdrawn and emphasize the importance of palliative care.

Main Methods:

  • Literature review on end-of-life care in neonatology.
  • Analysis of ethical guidelines and clinical practices.
  • Synthesis of factors influencing parental decisions and interdisciplinary team communication.

Main Results:

  • Identification of criteria for considering the withholding or withdrawal of life-sustaining treatment.
  • Explanation of the complex decision-making process involving parents, medical teams, and ethical considerations.
  • Emphasis on the necessity of high-quality palliative care following treatment limitation.

Conclusions:

  • Withholding or withdrawing life-sustaining treatment can be in the best interest of some extremely preterm or sick newborns.
  • A structured approach to decision-making, parental involvement, and conflict resolution is crucial.
  • Comprehensive palliative care is essential after the limitation of life-sustaining treatments.

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