Limitation of life-sustaining treatment in NICU: Physicians' beliefs and attitudes in the Buenos Aires region

Silberberg, Agustín; Herich, Lena Carolin; Croci, Ileana; Cuttini, Marina; Villar, Marcelo J.; Meana, Pablo Requena

doi:10.1016/j.earlhumdev.2020.104955

Cited by 11 publications

(13 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…18 There are many ethical discussions surrounding the decision to stop EOL care, and it is a very overwhelming responsibility. 20 The decision to stop life-sustaining treatment was deemed unacceptable and unjustifiable to almost all of the participants. However, very limited studies in the literature have explored nurses' perceptions and standpoint regarding EOL decision making.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Neonatal Nurses' Perceptions and Needs of End-of-Life Care Practice

Shattnawi

Younis

Omran

2022

J Hosp Palliat Nurs

View full text Add to dashboard Cite

End-of-life (EOL) care for newborns is challenging and requires well-prepared nurses to provide the best care for the dying baby and to prepare and support parents during such a difficult experience. This study aimed to explore Jordanian neonatal intensive care unit nurses' perceptions and needs regarding the provision of EOL care. This study used an exploratory descriptive qualitative approach and was conducted among a sample of 12 Jordanian neonatal intensive care unit nurses. Semistructured interviews were conducted to allow the nurses to describe their personal experiences and express their needs related to the provision of EOL care. Two main themes and 6 subthemes emerged from the analysis process. Main themes were (1) the challenges related to the provision of EOL care, and (2) nurses' needs: what matters most. The findings of this study shed light on neonatal care unit nurses' experiences and needs related to the provision of EOL care. The results of this study may be used to develop EOL care guidelines, programs, and protocols to be applied in intensive care units.

show abstract

Section: Discussionmentioning

confidence: 99%

“…There are many ethical discussions surrounding the decision to stop EOL care, and it is a very overwhelming responsibility 20 . The decision to stop life-sustaining treatment was deemed unacceptable and unjustifiable to almost all of the participants.…”

Section: Discussionmentioning

confidence: 99%

Neonatal Nurses' Perceptions and Needs of End-of-Life Care Practice

Shattnawi

Younis

Omran

2022

J Hosp Palliat Nurs

View full text Add to dashboard Cite

show abstract

“…It is interesting to note that a more favorable behavior regarding active management in trisomies 18 and 13 by Argentinean neonatologists could be part of a paradigm shift. 13 14 Until recently, these pathologies were considered as lethal diseases, incompatible with life. 3 20 The new paradigm would include an improved assessment of parental feelings, 21 the establishment of trust, and a value-based interaction, 22 and could be the result of a more open approach toward active management for some of these newborns.…”

Section: Discussionmentioning

confidence: 99%

“…Caring for life-threatening conditions such as trisomies 13 and 18 usually requires complex decision-making involving both parents and providers. In recent years, a paradigm shift appears to be happening regarding medical intervention in trisomies 18 and 13 5,[13][14][15][16] toward a more balanced view including patient-centered care, shared decision-making, and the option for invasive treatments.…”

mentioning

confidence: 99%

Attitudes of Argentinean Neonatologists toward Resuscitation of Infants with Trisomies 21, 18, and 13: A Multicenter Survey

et al. 2021

Self Cite

View full text Add to dashboard Cite

Objective This study was aimed to explore the attitude of Argentinean neonatologists in the delivery room on resuscitating infants with trisomies. Study Design An anonymous questionnaire was completed by neonatologists staffing level-III neonatal intensive care units (NICUs) on resuscitation of children with trisomies 21, 18, and 13. Potential sociocultural factors influencing the decision to resuscitate were included. Results Overall, 314 neonatologists in 34 units in the Buenos Aires region participated (response rate of 54%). The position of neonatologists regarding the resuscitation in the delivery room was that 98% would resuscitate newborns with trisomy 21, and 47% with trisomy 18 or trisomy 13. Resuscitation of newborns with trisomy 18 or trisomy 13 by neonatologists was significantly associated with working in the public sector, religious beliefs, and legal framework. Conclusion With improvement in the management and treatment of infants with trisomies 18 and 13, Argentinean neonatologists showed a favorable attitude toward resuscitating them in the delivery room. Key Points

show abstract

“…We do not yet have sufficient scientific evidence and medical experience to establish what the response of severely ill patients is, although we already know that it does have a prolonged acute phase (SIAARTI, 2020). In other circumstances, even more during circumstances of uncertainty, it is appropriate to have “more possibilities of response” (Silberberg et al, 2020). But in times of pandemics, as long as there are many other patients expecting immediate life-sustaining treatment, it seems reasonable that the waiting time should be shorter.…”

Section: Challenges In Modern Icusmentioning

confidence: 99%

Is shortening the response-to-treatment waiting time appropriate during the Covid-19 pandemic?

et al. 2020

Self Cite

View full text Add to dashboard Cite

Covid-19 is causing a catastrophic sanitary problem worldwide. Many countries find themselves in the midst of this sanitary problem, while others will soon be facing the same fate. The Covid-19 pandemic public health goal should not only be to protect the life of a few patients, but also to save the lives of as many patients as possible (Berlinger et al., 2020). If it were possible to save everyone, the duty would be straightforward and simply thatto save everyone. However, as we reach the peak of the pandemic, this may not be possible. That is why, utilizing all the means available (SEMICYUC, 2020), the duty is to save the life of as many patients as possible (Emanuel et al., 2020). There are many ethical dilemmas that have come out of the Covid-19 pandemic. The discussion about what the ethical parameters for medical decision-making should be is still open for consideration. Specifically, a few clinical strategies that consider the intrinsic dignity of the human person requires further elucidation. The aim of this paper, during Covid-19 pandemic's peak, is to consider whether it is appropriate to limit therapeutic efforts, knowing that the staying time in intense care units (ICUs) for patients with Covid-19 is significantly longer and that mortality rates are higher especially for those who do not demonstrate signs of improvement.

show abstract

Limitation of life-sustaining treatment in NICU: Physicians' beliefs and attitudes in the Buenos Aires region

Cited by 11 publications

References 32 publications

Neonatal Nurses' Perceptions and Needs of End-of-Life Care Practice

Neonatal Nurses' Perceptions and Needs of End-of-Life Care Practice

Attitudes of Argentinean Neonatologists toward Resuscitation of Infants with Trisomies 21, 18, and 13: A Multicenter Survey

Is shortening the response-to-treatment waiting time appropriate during the Covid-19 pandemic?

Contact Info

Product

Resources

About