The 'ouR-HOPE' approach for ethics and communication about neonatal neurological injury

Area of Science:

• Neonatal Neurology
• Medical Ethics
• Clinical Prognostication

Background:

• Accurate prediction of neurological outcomes in neonates with acute brain injury is vital for guiding treatment and care plans.
• Challenges in evidence-based prognostication include clinician bias and differing perceptions of disability, such as the disability paradox.

Purpose of the Study:

• To propose a framework, the ouR-HOPE approach, to address challenges in communicating prognosis for neonates with acute brain injury.
• To encourage clinicians' self-assessment and engagement in ethical prognosis communication.

Main Methods:

• Introduction of the "ouR-HOPE" approach: Reflection, Humility, Open-mindedness, Partnership, and Engagement.
• Development of guiding questions for clinicians to self-assess their prognostic communication practices.

Main Results:

• The ouR-HOPE approach provides a structured method for clinicians to reflect on and improve their practice.
• The proposed principles aim to foster more ethical and effective communication regarding neonatal neurological outcomes.

Conclusions:

• The ouR-HOPE approach offers a pathway to enhance ethical considerations in discussing prognosis for neonates with brain injuries.
• This framework encourages dialogue and attention to the complexities of communicating uncertain outcomes to families.