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Ethical decisions in the delivery room

J P Goldsmith1, H G Ginsberg, M C McGettigan

  • 1Department of Pediatrics, Ochsner Clinic, New Orleans, Louisiana, USA.

Clinics in Perinatology
|September 1, 1996
PubMed

Insights

Deciding when to withhold cardiopulmonary resuscitation (CPR) in infants with severe conditions is ethically complex. This differentiation aims to prevent prolonged suffering and reduce emotional and economic burdens.

Area of Science:

  • Neonatal Medicine
  • Medical Ethics

Background:

  • Cardiopulmonary resuscitation (CPR) is a critical intervention for infants in cardiopulmonary arrest.
  • Decisions regarding withholding CPR in neonates are ethically challenging due to potential for prolonged suffering and significant family/societal costs.

Purpose of the Study:

  • To explore the ethical underpinnings of withholding CPR in neonates.
  • To identify key diagnostic categories where CPR decisions are most difficult.

Main Methods:

  • Ethical analysis of decision-making frameworks in the delivery room (DR).
  • Review of common neonatal diagnoses associated with difficult CPR decisions.

Main Results:

  • Ethical justification for withholding futile therapies that prolong suffering.
  • Identification of three primary diagnostic groups requiring careful CPR consideration: severe congenital defects, extremely low birthweight infants, and infants with severe perinatal asphyxia.

Conclusions:

  • Differentiating infants with extremely poor prognoses or extensive defects is crucial for avoiding futile treatments.
  • Ethical decision-making in the DR is paramount when considering CPR for vulnerable neonates.

Keywords:
Death and EuthanasiaProfessional Patient Relationship

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