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End-of-life decisions and practices for very preterm infants in the Wallonia-Brussels Federation of Belgium
- Source :
- BMC Pediatrics, Vol. 18, no. 1, p. 10p. (2018), BMC Pediatrics, BMC Pediatrics, Vol 18, Iss 1, Pp 1-10 (2018), BMC pediatrics, 18 (1
- Publication Year :
- 2018
- Publisher :
- Springer Nature, 2018.
-
Abstract
- Background: Very preterm birth (24 to < 32 week's gestation) is a major public health issue due to its prevalence, the clinical and ethical questions it raises and the associated costs. It raises two major clinical and ethical dilemma: (i) during the perinatal period, whether or not to actively manage a baby born very prematurely and (ii) during the postnatal period, whether or not to continue a curative treatment plan initiated at birth. The Wallonia-Brussels Federation in Belgium counts 11 neonatal intensive care units. Methods: An inventory of key practices was compiled on the basis of an online questionnaire that was sent to the 65 neonatologists working in these units. The questionnaire investigated care-related decisions and practices during the antenatal, perinatal and postnatal periods, as well as personal opinions on the possibility of standardising and/or legislating for end-of-life decisions and practices. The participation rate was 89% (n = 58). Results: The results show a high level of homogeneity pointing to overall agreement on the main principles governing curative practice and the gestational age that can be actively managed given the current state of knowledge. There was, however, greater diversity regarding principles governing the transition to end-of-life care, as well as opinions about the need for a common protocol or law to govern such practices. Conclusion: Our results reflect the uncertainty inherent in the complex and diverse situations that are encountered in this extreme area of clinical practice, and call for qualitative research and expert debates to further document and make recommendations for best practices regarding several "gray zones" of end-of-life care in neonatology, so that high quality palliative care may be granted to all neonates concerned with end-of-life decisions.<br />SCOPUS: ar.j<br />info:eu-repo/semantics/published
- Subjects :
- Male
Parents
Palliative care
Computer-assisted web interviewing
Pediatrics
0302 clinical medicine
Belgium
Neonatologists
Surveys and Questionnaires
030212 general & internal medicine
Practice Patterns, Physicians'
Survey
Terminal Care
lcsh:RJ1-570
Uncertainty
Middle Aged
Perinatology
and Child Health
Perinatal Care
Infant, Extremely Premature
Female
Research Article
NICU
Adult
medicine.medical_specialty
Attitude of Health Personnel
Pédiatrie
Best practice
Clinical Decision-Making
Decision Making
Gestational Age
03 medical and health sciences
030225 pediatrics
Intensive care
Intensive Care Units, Neonatal
medicine
Very Preterm Birth
Humans
business.industry
Public health
Infant, Newborn
lcsh:Pediatrics
Preterm birth
Withholding Treatment
Family medicine
Pediatrics, Perinatology and Child Health
Ethical dilemma
business
Qualitative research
End-of-life
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- BMC Pediatrics, Vol. 18, no. 1, p. 10p. (2018), BMC Pediatrics, BMC Pediatrics, Vol 18, Iss 1, Pp 1-10 (2018), BMC pediatrics, 18 (1
- Accession number :
- edsair.doi.dedup.....519e9777158944abc7761e503e2ea001