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Values-based shared decision-making in the antenatal period

Stephanie K Kukora1, Renee D Boss2

  • 1University of Michigan Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Ann Arbor, MI, USA; Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, MI, USA.

Seminars in Fetal & Neonatal Medicine
|September 18, 2017
PubMed

Insights

Parents face difficult decisions for critically ill newborns. Understanding parental values is crucial for improving shared decision-making and infant care, enhancing coping, and reducing regret.

Area of Science:

  • Neonatal medicine
  • Bioethics
  • Parental decision-making

Background:

  • Advances in neonatal care present challenges for extremely premature infants, those with congenital anomalies, or genetic conditions.
  • Parents of critically ill neonates must make difficult decisions about supportive care, balancing benefits and burdens.
  • Current guidelines emphasize parental values, but these values and their application in complex situations are poorly understood.

Purpose of the Study:

  • To investigate how parents derive their values when making decisions for critically ill neonates.
  • To explore how clinicians can effectively engage with parents regarding their values.
  • To inform interventions that enhance shared decision-making in neonatal intensive care.

Main Methods:

  • Systematic investigation of parental values in neonatal care decisions.
  • Exploration of the interplay between parental values, clinical complexity, uncertainty, and emotionality.
  • Analysis of how clinicians can best support parents in value-based decision-making.

Main Results:

  • Limited understanding of parental values in neonatal end-of-life care decisions.
  • Identification of key factors influencing parental value derivation and application.
  • Need for improved clinician-parent communication strategies.

Conclusions:

  • Further research is needed to understand parental values in neonatal care.
  • Developing interventions to enhance shared decision-making is essential.
  • Improving decision-making processes can enhance parental coping, resilience, and satisfaction, while minimizing regret.

Keywords:
Antenatal counselingShared decision-makingValues

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