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J Matern Fetal Neonatal Med. 2012 Jul;25(7):984-91. doi: 10.3109/14767058.2011.602442. Epub 2011 Aug 30.

Ethics in neonatology: a look over Europe.

Author information

  • 1Faculty of Medicine, Porto University, Porto, Portugal. herciliaguimaraes@gmail.com

Abstract

Advances in perinatal medicine have dramatically improved neonatal survival. End-of-life decision making for newborns with adverse prognosis is an ethical challenge, the ethical issues are controversial and little evidence exists on attitudes and values in Europe.

OBJECTIVE:

to assess the attitudes of the neonatal departments in perinatal clinical practice in the hospitals of European countries.

METHODS:

a questionnaire was send to 55 NICUs from 19 European countries.

RESULTS:

Forty five (81.8%) NICUs were Level III. Religion was Christian in 90.7% and we observed that in north countries the religion is more influent on clinical decisions (p = 0.032). Gestational age was considered with no significant difference for clinical investment. North countries consider birth weight (p = 0.011) and birth weight plus gestational age (p = 0.024) important for clinical investment. In north countries ethical questions should not prevail when the decision is made (p = 0.049) and from an ethical point of view, there is no difference between withdraw a treatment and do not initiate the treatment (p = 0.029). More hospitals in south countries administer any analgesia (p = 0.007). When the resuscitation is not successful 96.2% provide comfort care.

CONCLUSION:

Our study reveals that cultural and religious differences influenced ethical attitudes in NICUs of the European countries.

PMID:
21740325
[PubMed - indexed for MEDLINE]
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