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J Perinatol. 2016 Oct;36(10):906-11. doi: 10.1038/jp.2016.87. Epub 2016 Jun 2.

Three decades after Baby Doe: how neonatologists and bioethicists conceptualize the Best Interests Standard.

Author information

1
Section of Neonatology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.
2
Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA.

Abstract

OBJECTIVE:

The objective of this study is to determine how neonatologists and bioethicists conceptualize and apply the Best Interests Standard (BIS).

STUDY DESIGN:

Members of the American Society for Bioethics and Humanities and the American Academy of Pediatrics Section on Neonatal-Perinatal Medicine were surveyed to determine how they conceptualized the BIS and ranked the appropriateness of forgoing life-sustaining therapy (LST).

RESULTS:

Neonatologists' median response supported an infant-specific BIS conceptualization that linked the infant's and family's interests. They did not support allowing limitations on the family's obligations. Ethicists' supported a conceptualization that linked the infant's and family's interests and limitations on the family's obligations, a less infant-specific conceptualization. Ethicists were less or equally likely to agree with forgoing LST in seven of eight cases.

CONCLUSIONS:

Ethicists endorsed a conceptualization of the BIS that includes the effects on the family and rejected an infant-specific one. Neonatologists split between these two and rejected limiting the family's obligations. Critical appraisal of the BIS is needed in neonatal ethics.

PMID:
27253891
PMCID:
PMC5490658
DOI:
10.1038/jp.2016.87
[Indexed for MEDLINE]
Free PMC Article

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