Literature DB >> 9220330

Decision-making in the critically ill neonate: cultural background v individual life experiences.

C Hammerman1, E Kornbluth, O Lavie, P Zadka, Y Aboulafia, A I Eidelman.   

Abstract

OBJECTIVES: In treating critically ill neonates, situations occasionally arise in which aggressive medical treatment prolongs the inevitable death rather than prolonging life. Decisions as to limitation of neonatal medical intervention remain controversial and the primary responsibility of the generally unprepared family. This research was designed to study response patterns of expectant mothers towards treatment of critically ill and/or malformed infants. DESIGN/
SETTING: Attitudes were studied via comprehensive questionnaires divided into three sections: 1-Sociodemographic data and prior personal experience with perinatal problems; 2-Theoretical philosophical principles used in making medical ethical decisions; and 3-Hypothetical case scenarios with choices of treatment options. SUBJECTS AND
RESULTS: Six hundred and fifty pregnant women were studied. Maternal birthplace (p = 0.005) and level of religious observance (p = 0.02) were strongly associated with the desire for maximally aggressive medical intervention in the hypothetical case scenario. Specific personal experiences such as infertility problems, previous children with serious mental or physical problems were not correlated with the selection of different treatment choices. Of the theoretical principles studied, only the desire to preserve life at all costs was significantly associated with the choice for maximal medical treatment (p = 0.003).
CONCLUSIONS: Maternal ethnocultural background and philosophical principles more profoundly influenced medical ethical decision-making than did specific personal life experiences.

Entities:  

Keywords:  Death and Euthanasia; Empirical Approach; Jerusalem; Religious Approach

Mesh:

Year:  1997        PMID: 9220330      PMCID: PMC1377345          DOI: 10.1136/jme.23.3.164

Source DB:  PubMed          Journal:  J Med Ethics        ISSN: 0306-6800            Impact factor:   2.903


  8 in total

Review 1.  Ethical dilemmas of neonatal--perinatal surgery.

Authors:  A L Rostain; V K Bhutani
Journal:  Clin Perinatol       Date:  1989-03       Impact factor: 3.430

Review 2.  Meningomyelocele in the neonate: medical and ethical considerations.

Authors:  A Steinberg
Journal:  J Perinatol       Date:  1991-03       Impact factor: 2.521

Review 3.  Ethical issues presented by children with congenital anomalies.

Authors:  S Segal
Journal:  Semin Perinatol       Date:  1992-12       Impact factor: 3.300

4.  Life-saving therapy for newborns: a questionnaire survey in the state of Massachusetts.

Authors:  I D Todres; J Guillemin; M A Grodin; D Batten
Journal:  Pediatrics       Date:  1988-05       Impact factor: 7.124

5.  Caring for newborns: three world views. In Israel, families look to two messengers of God.

Authors:  A I Eidelman
Journal:  Hastings Cent Rep       Date:  1986-08       Impact factor: 2.683

6.  Ethical decision-making and neonatal resuscitation.

Authors:  P J Byrne; J M Tyebkhan; L M Laing
Journal:  Semin Perinatol       Date:  1994-02       Impact factor: 3.300

7.  Jewish medical ethics--a brief overview.

Authors:  I Jakobovits
Journal:  J Med Ethics       Date:  1983-06       Impact factor: 2.903

8.  The Jerusalem perinatal study: the first decade 1964--73.

Authors:  S Harlap; A M Davies; N B Grover; R Prywes
Journal:  Isr J Med Sci       Date:  1977-11
  8 in total
  4 in total

1.  Decision making in the critically ill neonate.

Authors:  M H Kottow
Journal:  J Med Ethics       Date:  1998-08       Impact factor: 2.903

2.  Migrant and minority family members in the intensive care unit. A review of the literature.

Authors:  KettyElena Quindemil; Martin Nagl-Cupal; Kathryn Hoehn Anderson; Hanna Mayer
Journal:  HeilberufeScience       Date:  2013-11

3.  Opinions of Argentinean neonatologists on the initiation of life-sustaining treatment in preterm infants.

Authors:  Agustín Silberberg; Marcelo José Villar; Silvio Torres
Journal:  Health Sci Rep       Date:  2018-10-20

4.  Promoting neonatal staff nurses' comfort and involvement in end of life and bereavement care.

Authors:  Weihua Zhang; Betty S Lane
Journal:  Nurs Res Pract       Date:  2013-03-27
  4 in total

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