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Acta Paediatr. 2017 Mar;106(3):423-429. doi: 10.1111/apa.13680. Epub 2016 Dec 22.

Attitudes towards decisions about extremely premature infants differed between Swiss linguistic regions in population-based study.

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Department of Neonatology, Perinatal Centre, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zurich, Switzerland.
Dialogue Ethics Foundation, Interdisciplinary Institute for Ethics in Healthcare, Zurich, Switzerland.



Studies have provided insights into the different attitudes and values of healthcare professionals and parents towards extreme prematurity. This study explored societal attitudes and values in Switzerland with regard to this patient group.


A nationwide trilingual telephone survey was conducted in the French-, German- and Italian-speaking regions of Switzerland to explore the general population's attitudes and values with regard to extreme prematurity. Swiss residents of 18 years or older were recruited from the official telephone registry using quota sampling and a logistic regression model assessed the influence of socio-demographic factors on end-of-life decision-making.


Of the 5112 people contacted, 1210 (23.7%) participated. Of these 5% were the parents of a premature infant and 26% knew parents with a premature infant. Most participants (77.8%) highlighted their strong preference for shared decision-making, and 64.6% said that if there was dissent then the parents should have the final word. Overall, our logistic regression model showed that regional differences were the most significant factors influencing decision-making.


The majority of the Swiss population clearly favoured shared decision-making. The context of sociocultural demographics, especially the linguistic region in which the decision-making took place, strongly influenced attitudes towards extreme prematurity and decision-making.


End-of-life decision-making; Extreme prematurity; Moral pluralism; Population survey; Shared decision-making

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