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Consent for routine neonatal procedures: A study of practices in Irish neonatal units. How do we compare with the
M A Ryan1, C A Ryan1, E Dempsey1
1Department of Neonatology, Cork University Maternity Hospital, Wilton, Cork.
Insights
Irish neonatal units show inconsistent consent practices for routine procedures, deviating from British Association of Perinatal Medicine guidelines. This highlights a need for standardized consent procedures in neonatal care.
Area of Science:
- Neonatal Medicine
- Healthcare Policy
- Informed Consent Law
Background:
- The Irish National Consent Policy (NCP) mandates consent for all Health Service Executive (HSE) interventions.
- Informed consent is a cornerstone of ethical medical practice, particularly in vulnerable neonatal populations.
- Variability in consent practices can lead to ethical and legal challenges.
Purpose of the Study:
- To quantitatively assess current consent practices for routine neonatal procedures in Ireland.
- To compare these practices against the British Association of Perinatal Medicine (BAPM) guidelines.
- To identify areas of consistency and inconsistency in neonatal consent procedures nationwide.
Main Methods:
- A quantitative descriptive study design was employed.
- Data were collected from neonatal facilities across Ireland.
- Practices for obtaining consent for specific neonatal procedures were investigated.
Main Results:
- Significant inconsistencies were found in consent modes across participating neonatal units.
- Practices frequently varied from the BAPM 'gold standard' guidelines.
- Unanimity in consent procedures was observed for only three specific interventions (BCG, 6-in-1 vaccine, donor breast milk).
Conclusions:
- There is a lack of standardized consent procedures for neonatal care in Ireland.
- Specific complex procedures like EEG with video, MRI/CT, GI imaging, and lumbar punctures showed notable consent variances.
- Recommendations for improved consistency and adherence to guidelines are warranted.
Abstract:
The Irish National Consent Policy (NCP) proposes that the legal requirement for consent extends to all forms of interventions, investigations and treatment, carried out on or behalf of the Health Service Executive (HSE). This study employs a quantitative descriptive approach to investigate the practices for obtaining consent for an identified group of routine neonatal procedures in neonatal facilities throughout Ireland. The BAPM (British Association of Perinatal Medicine) guidelines were identified as 'gold standard' for the purposes of this study. The results indicated a lack of consistency between participating units pertaining to the modes of consent utilised and notable variances from 'gold standard' guidelines. Unanimity was evident for 3 procedures only (administering BCG, 6-in-1, and donor breast milk to infant). Significant findings related to EEG with video recordings, MRI/CT and gastro intestinal imaging, screening of an infant with suspected substance abuse or retinopathy of prematurity screening (ROP), administration of Vitamin K, and the carrying out of a lumbar puncture.
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