Category: Ethics

WWLST in VLBW Neonates

A retrospective 18-center analysis of data on very low birth weight infants found that discussions about withholding or withdrawal of life-sustaining therapy (WWLST) occurred more often in infants 22 – 24 weeks gestation (27%) than in those 27-28 weeks (6%). There…

Moral distress in intensive care

Moral distress is anguish experienced when an individual makes a clear moral judgment about an action to take but is unable to act accordingly due to societal, institutional or contextual constraints. A systematic review of 13 studies on moral distress…

Vindication for the SUPPORT trial

Investigators of the SUPPORT trial have been criticized and accused (by parents and by the Office of Human Research Protection) of causing harm to babies enrolled in the trial even though this study was approved by multiple institutional review boards.…

Structured ethical decision-making in a NICU

A study from the Netherlands describes how a NICU implemented a structured approach to multidisciplinary discussions and decisions for difficult ethical decisions. Meetings were chaired by an ethicist and a special online form was used to guide the discussions and summarize…

Ten tips for interacting with parents of NICU babies

The emotional and psychological needs of parents of NICU babies are often not addressed by NICU health professionals, even when the medical care of the infants is optimal. A checklist of ten items is offered in  a special article that…

Incidental discovery of nonparentage – to disclose or not?

When newborns and children undergo laboratory tests, the results occasionally indicate that one of the supposed parents cannot be the genetic parent that he or she is supposed to be. Such incidental findings of nonparentage can cause considerable distress to…

Periviable birth: Workshop summary

The findings of a Joint Workshop held by leading organizations in obstetric and pediatric/neonatal care were recently published in multiple journals and contains summaries and recommendations about obstetric and neonatal management. Highlights of this report: The term perviable birth was…

The dying neonate – a mother’s perspective

An article written by the mother of a critically ill 24 week gestation infant describes the emotions that parents experience when in the throes of intensive care decisions. There are tips to NICU professionals on how best to interact with…

Dilemmas in the care of extremely preterm infants – an essay

An essay written by a neonatologist describes the dilemmas faced by NICU teams when faced with decisions about resuscitation of extremely preterm infants. In the ‘Gray Zone’. Suresh 2013 Listen to the podcast Tweet

Saving versus creating: implicit bias against newborns

Ethical principles of resuscitation should be applied uniformly to neonates, older children and adults. However, many health professionals are willing to withhold or withdraw life-sustaining therapy in newborns at high risk of disability (e.g., a baby born at 24 weeks…

Do Facebook pictures of babies violate their privacy?

An amusing but thought-provoking article describes how a baby has a brain, but not a mind. It does not have agency and has not yet developed personhood. So by posting pictures of a baby on Facebook, are parents violating the…

Baby hatches – beneficial or harmful?

A baby hatch is a location where parents can abandon an unwanted newborn baby (sometimes anonymously), and such hatches exist in 20 countries, often outside hospitals. They are intended to save the lives of fetuses and newborns. An article from…