Care at the edge of viability: medical and ethical issues

Decision-making for extremely immature preterm infants at the margins of viability is ethically, professionally, and emotionally complicated. A standard for prenatal consultation should be developed incorporating assessment of parental decision-making preferences and styles, a communication process...

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Bibliographic Details
Published inClinics in perinatology Vol. 38; no. 3; p. 471
Main Authors Haward, Marlyse F, Kirshenbaum, Nancy W, Campbell, Deborah E
Format Journal Article
LanguageEnglish
Published United States 01.09.2011
Subjects
Counseling - ethics
Decision Making - ethics
Female
Fetal Viability
Humans
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight
Pregnancy
Prenatal Care - ethics
Prenatal Care - psychology
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Summary:Decision-making for extremely immature preterm infants at the margins of viability is ethically, professionally, and emotionally complicated. A standard for prenatal consultation should be developed incorporating assessment of parental decision-making preferences and styles, a communication process involving a reciprocal exchange of information, and effective strategies for decisional deliberation, guided by and consistent with parental moral framework. Professional caregivers providing perinatal consultations or end-of-life counseling for extremely preterm infants should be sensitive to these issues and be taught flexibility in counseling techniques adhering to consistent guidelines. Emphasis must shift away from physician beliefs and behaviors about the boundaries of viability.
ISSN:1557-9840
DOI:10.1016/j.clp.2011.06.004