Parental Decision-Making Preferences in Neonatal Intensive Care

Area of Science:

• Neonatal Medicine
• Pediatric Decision-Making
• Bioethics

Background:

• Parents of critically ill infants in the neonatal intensive care unit (NICU) face complex medical decisions.
• Understanding parental preferences for decision control is crucial for effective communication and shared decision-making.
• Existing research has not fully elucidated how specific medical decision characteristics influence these preferences.

Purpose of the Study:

• To investigate how the characteristics of medical decisions influence parents' preferences for control over these decisions for their seriously ill infants.
• To identify factors that make parents prefer to delegate decisions to the medical team versus retaining control themselves.

Main Methods:

• Qualitative interviews were conducted with parents of infants in the NICU.
• Parents recalled and discussed medical decisions, detailing who made them and their preferred decision-maker.
• Standard qualitative methods were used to code responses and analyze decision characteristics against preferred decision-making roles.

Main Results:

• Parents preferred delegating decisions to the medical team when decisions involved high urgency or required high medical expertise.
• Parents preferred retaining control when decisions involved high perceived risk, their personal experience, bodily fluids, or aligned with their perceived parental role.

Conclusions:

• Decision characteristics significantly influence parental preferences for control in neonatal intensive care unit (NICU) medical decision-making.
• These findings can inform strategies to improve physician-parent communication and the informed consent process.