Neonatal Med.  2017 May;24(2):77-82. 10.5385/nm.2017.24.2.77.

Investigation of Neonatal Staff Members' Attitudes toward End-of-Life Decision Making about Dying Newborns

• Lee JH
• Cho SY
• Kwon KA
• Kim MJ

• KMID: 2379658
• DOI: http://doi.org/10.5385/nm.2017.24.2.77

Abstract

PURPOSE
The objective of this study was to investigate physicians' attitudes toward ethical end-of-life decision making about dying newborns.
METHODS
Between October and December 2015, we surveyed 185 neonatal staff members working at 6 neonatal intensive care units to investigate their attitudes toward ethical end-of-life decision making about dying newborns.
RESULTS
The respondents generally agreed with using sedatives/analgesics to suppress pain despite the risk of fatality (80%), continuing current treatment without using other treatment methods (56.2%), and withholding emergency treatment in the form of cardiac arrest resuscitation (48.1%). In contrast, most respondents disagreed with administering drugs for the purpose of ending life, withholding neonatal intensive care, and withholding mechanical ventilation. Although the respondents believed that it is necessary to suggest that the parents of dying neonates sign do-not-resuscitate (DNR) orders (62.7%), most of them found it difficult to talk to parents/families about DNR orders (90.8%), or wanted to refrain from obtaining families' consent in person (84.9%).
CONCLUSION
Korean neonatal staff members believed that withholding or withdrawal of treatment is necessary when making ethical decisions about dying neonates; however, they preferred to use conservative, rather than active interventions.

Keyword

End-of-life care; Ethics; Neonatal intensive care units; Newborns

MeSH Terms

Decision Making*
Emergency Treatment
Ethics
Heart Arrest
Humans
Infant, Newborn*
Intensive Care Units, Neonatal
Intensive Care, Neonatal
Parents
Respiration, Artificial
Resuscitation
Surveys and Questionnaires