An ethical dilemma in the neonatal intensive care unit: providing due care

We have discussed the ethical principles of beneficence, nonmaleficence, fidelity, and justice as they relate to a case involving what to do when there are too many sick neonates in an NICU. The use of ethical principles clarified the issues surrounding the shift in power and the decision making. This clarification led to the various short-term and long-term strategies that were designed to resolve the ethical dilemma. In addition, analysis of this case demonstrates that issues related to justice frequently involve the making or the questioning of policy so that all can be treated in a fair way. Providing for individuals in a fair manner reduces the potential for harm. Focusing on ethical principles may serve to deemphasize and diffuse the control and territorial issues that may arise in similar cases. This refocusing will then enable all parties to address their common concern--how to provide due care to sick neonates and their families.