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Communication with parents concerning withholding or withdrawing of life-sustaining interventions in neonatology
Authors:Annie Janvier  Keith Barrington  Barbara Farlow
Affiliation:1. Department of Pediatrics and Clinical Ethics, University of Montreal, Montreal, Quebec, Canada;2. Sainte-Justine Hospital, Montreal, Quebec, Canada;3. Department of Pediatrics, University of Montreal, Montreal, Quebec, Canada;4. The DeVeber Center for Bioethics and Social Research, Canada;5. Patients for Patient Safety Canada, Canada
Abstract:The nature and content of the conversations between the healthcare team and the parents concerning withholding or withdrawing of life-sustaining interventions for neonates vary greatly. These depend upon the status of the infant; for some neonates, death may be imminent, while other infants may be relatively stable, yet with a potential risk for surviving with severe disability. Healthcare providers also need to communicate with prospective parents before the birth of premature infants or neonates with uncertain outcomes. Many authors recommend that parents of fragile neonates receive detailed information about the potential outcomes of their children and the choices they have provided in an unbiased and empathetic manner. However, the exact manner this is to be achieved in clinical practice remains unclear.
Keywords:BPD, bronchopulmonary dysplasia   PMA, post-menstrual age   CPR, cardiopulmonary resuscitation   ELGAN, extremely low-gestational-age infants   GA, gestational age   NEC, necrotizing enterocolitis   NICU, neonatal intensive care unit
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