In The ‘Gray Zone,’ A Doctor Faces Tough Decisions On Infant Resuscitation

Of the few very premature babies who survive, many end up with severe handicaps, including mental retardation, cerebral palsy, blindness, and deafness. Because of this bleak prognosis, they -- the neonatologists, neonatal nurse practitioners, nurses, and other neonatal intensive care unit staff who...

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Bibliographic Details
Published in:Health Affairs 2013-10, Vol.32 (10), p.1841-1845
Main Author: Suresh, Gautham K.
Format: Article
Language:English
Subjects:
Decision making
Gestational age
Hospitals
Intensive care
Medical personnel
Neonatal care
Neonatal nursing
Nurse practitioners
Nurses
Obstetrics
Pain
Patients
Pregnancy
Premature babies
Premature birth
Prenatal care
Ultrasonic imaging
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Summary:Of the few very premature babies who survive, many end up with severe handicaps, including mental retardation, cerebral palsy, blindness, and deafness. Because of this bleak prognosis, they -- the neonatologists, neonatal nurse practitioners, nurses, and other neonatal intensive care unit staff who care for extremely premature babies -- often face impossible decisions: to provide intensive care to such babies or step back and not intervene. In an ideal world, decisions about the care of these borderline babies should follow the principles of shared decision making based on in-depth, compassionate discussions between the parents and health professionals before the baby is born. Health professionals should provide information and ensure that the patient understands what is at stake. They must identify the expectant parents' values and preferences; make recommendations if the parents desire; and ultimately help them make choices about when to initiate, continue, or withdraw intensive care.
ISSN:0278-2715
1544-5208
DOI:10.1377/hlthaff.2013.0677