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Defining futility in neonatal intensive care
1University of Texas at Austin School of Nursing, Austin, USA.
Insights
Defining futility in neonatal intensive care is crucial for ethical treatment decisions. This article proposes criteria for identifying futility based on infant response to therapy for extreme prematurity.
Area of Science:
- Neonatal Medicine
- Medical Ethics
- Clinical Practice
Background:
- Neonatal intensive care for extreme prematurity presents complex ethical challenges.
- The concept of "futility" in treatment is debated and lacks clear definition in this context.
Purpose of the Study:
- To propose an initial conceptualization of futility in neonatal intensive care.
- To stimulate debate and further development of the concept of treatment futility.
Main Methods:
- Conceptual analysis of futility in the context of neonatal care.
- Defining futility based on infant response to therapeutic interventions for extreme prematurity.
Main Results:
- Futility is conceptualized in relation to an infant's response to a trial of therapy.
- Criteria for determining futility focus on sustained physiologic complications linked to mortality and morbidity.
Conclusions:
- A clear conceptualization of futility is needed to guide clinical decisions.
- Further research and discussion are required to refine the criteria for determining futility in neonatal intensive care.
Abstract:
This article presents an initial conceptualization of futility in neonatal intensive care in an attempt to stimulate thoughtful debate an further development of the concept. Futility is defined within the context of the infant's response to a trial of therapy for extreme prematurity. Substantial criteria for determining whether futility has been reached focus on whether the infant has sustained physiologic complications that have been shown in follow-up studies to be related to mortality and significant morbidity.