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Treatment of seriously ill and handicapped newborns
1Department of Pediatrics, University of Wisconsin School of Medicine, Madison.
Insights
Decisions about withdrawing life-sustaining treatment for infants involve complex ethical choices. This article explores historical context, ethical principles, and a procedural approach to guide these difficult medical decisions.
Area of Science:
- Medical Ethics
- Bioethics
- Healthcare Law
Background:
- Medical advancements enable life prolongation, raising ethical dilemmas regarding treatment withdrawal.
- Disagreements persist on decision-making authority and guiding principles for infant life-sustaining treatment.
Purpose of the Study:
- To review the history of the controversy surrounding life-sustaining treatment decisions for infants.
- To analyze major ethical principles guiding these decisions.
- To present arguments for a procedural approach to decision-making.
Main Methods:
- Historical review of the controversy.
- Analysis of substantive ethical principles.
- Argumentation for a procedural approach.
Main Results:
- The history of the debate on withholding or withdrawing life-sustaining treatment is presented.
- Key ethical principles are analyzed.
- A procedural approach is advocated.
Conclusions:
- Ethical considerations in pediatric end-of-life care are complex.
- A procedural framework may offer a structured method for difficult decisions.
- Further interest in procedural approaches is noted.
Abstract:
Medical technology makes it increasingly possible to prolong life, sometimes indefinitely in the face of overwhelming disability or suffering; thus, choices must be made whether to withhold or withdraw life-sustaining treatment. Reasonable people disagree about who should make such decisions when the patient is an infant, and what principles or rules should guide them. The article briefly reviews the recent history of this controversy analyzes the major ethical substantive principles that have been proposed to guide conduct, and presents the arguments for a procedural approach that is now attracting interest.