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Updated: May 13, 2025

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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Published on: August 25, 2014

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Ethical Complexities of Neonatal Neurocritical Care

Alexandra Lazzara1, Renee D Boss2

  • 1Division of Neonatology, Johns Hopkins School of Medicine, 1800 Orleans Street, Bloomberg 8524, Baltimore, MD 21287, USA.

Clinics in Perinatology
|May 11, 2025
PubMed

Insights

Ethical challenges in infant neurology are growing. This review examines genetic conditions, intraventricular hemorrhage, and hypoxic-ischemic encephalopathy, focusing on disability values and end-of-life care decisions.

Area of Science:

  • Neonatal Neurology
  • Medical Ethics
  • Pediatric Neuroethics

Background:

  • Neurologic interventions for infants have advanced significantly.
  • These advancements introduce complex ethical dilemmas in neonatal care.
  • Ethical considerations are crucial in managing complex neonatal neurologic conditions.

Purpose of the Study:

  • To review three specific neonatal neurologic conditions.
  • To highlight the ethical challenges associated with these conditions.
  • To discuss the intersection of evolving social values with clinical decision-making.

Main Methods:

  • Review of current literature on neonatal neurologic conditions.
  • Analysis of ethical challenges within and across selected conditions.
  • Discussion of societal values impacting care decisions.

Main Results:

  • Identified key ethical issues in genetic conditions, intraventricular hemorrhage with posthemorrhagic ventricular dilation, and hypoxic-ischemic encephalopathy.
  • Highlighted the impact of evolving social values on perceptions of cognitive disability.
  • Examined prognostic uncertainty and its role in treatment decisions.
  • Discussed ethical considerations surrounding withdrawal of life-sustaining therapies.

Conclusions:

  • Neonatal neurologic interventions necessitate careful ethical navigation.
  • Understanding evolving social values is critical for ethical care.
  • Prognostic uncertainty and end-of-life decisions require sensitive ethical approaches.

Keywords:
EthicsGeneticHypoxic-ischemic encephalopathyIntraventricular hemorrhagePrematurity

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