Withholding treatment, withdrawing treatment, and palliative care in the neonatal intensive care unit.

Abstract:

:Advances in pharmacology and technology have sharply reduced mortality of extremely preterm infants at the expense of an increasing number of survivors with handicaps and disabilities. The EURONIC study among neonatal intensive care units across Europe demonstrates that treatment of infants born at the limits of viability raises challenging ethical, moral, legal, and emotional dilemmas among neonatologists, nurses, and parents alike. When is it wise to withhold or withdraw intensive care and, if so, what are the needs of the nonviable or dying infant, family, and neonatal staff to provide a humane and compassionate death? This process begins with a thorough determination of diagnosis and prognosis, followed by decision making on the basis of futility of treatment or quality-of-life issues, and counseling of parents. Withholding or withdrawing of intensive care should be synonymous with palliative care. Perinatal audit and after-care of the family complete the process. The Dutch viewpoint and practice guidelines on withholding and withdrawing of neonatal intensive care are presented.

journal_name

Early Hum Dev

journal_title

Early human development

authors

Walther FJ

doi

10.1016/j.earlhumdev.2005.10.004

keywords:

subject

Has Abstract

pub_date

2005-12-01 00:00:00

pages

965-72

issue

12

eissn

0378-3782

issn

1872-6232

pii

S0378-3782(05)00194-5

journal_volume

81

pub_type

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