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Injustice and inequality in the provision of perinatal palliative care

Matthew Lin1, Sophie Bertaud2, Dominic Wilkinson3

  • 1New York University Grossman School of Medicine, Department of Pediatrics, Division of Neonatology, New York, NY, USA; New York University School Grossman of Medicine, Department of Pediatrics, Pediatric Advanced Care Team, New York, NY, USA.

Seminars in Perinatology
|June 4, 2025
PubMed

Insights

Perinatal palliative care (PnPC) offers holistic support for families facing a baby’s life-limiting diagnosis. This study highlights inequities in access to PnPC, advocating for its availability to all families as a crucial capability.

Area of Science:

  • Medical Ethics
  • Neonatal Care
  • Health Equity

Background:

  • Perinatal palliative care (PnPC) is an emerging field within pediatric palliative care.
  • It provides comprehensive support during the antenatal, delivery, and neonatal periods.
  • Ethical considerations, particularly justice-based issues, surrounding PnPC access remain underexplored.

Purpose of the Study:

  • To explore justice-based ethical questions concerning the provision of perinatal palliative care.
  • To identify and describe existing inequities in accessing and delivering PnPC.
  • To advocate for equitable access to PnPC for all eligible families.

Main Methods:

  • Philosophical analysis using the Capabilities Approach.
  • Examination of ethical principles related to healthcare access and provision.
  • Review of current practices and disparities in perinatal palliative care.

Main Results:

  • Significant inequities exist in who receives perinatal palliative care support.
  • Access to and delivery of PnPC are not uniformly equitable across all families.
  • The study identifies a gap between the need for PnPC and its actual availability.

Conclusions:

  • Perinatal palliative care is a valuable capability for infants with life-limiting conditions and their families.
  • Health professionals must actively promote and advocate for universal access to PnPC.
  • Ensuring equitable access to PnPC aligns with principles of justice and comprehensive care.

Keywords:
EthicsJusticeNeonatologyPediatric palliative carePerinatal palliative care

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