Perinatale Palliativversorgung

Palliative Care and Grief Counseling in Peri- and Neonatology: Recommendations From the German PaluTiN Group

“…We assigned those topics one-by-one to a subgroup of our expert panel with particular experience in that respective sub-area to foster the process of a common discussion and endeavor the draft of a recommendation in that special field. Whenever available, recommendations were developed based on (i) guidelines of (inter)national health care and development organizations (13)(14)(15)(16), (ii) systematic reviews, position papers and recommendations (1,(3)(4)(5)(6)6, 17-53) (iii) individual studies that were identified by reviewing the reference lists of the systematic reviews, position papers and recommendations, and (iv) textbooks most frequently used in daily German clinical practice (54)(55)(56)(57)(58)(59)(60)(61)(62). The evidence was combined with expert opinion of the panel team members.…”

“…The parents' assessment of the child's condition should be taken into account. Appropriate pain management and symptom control (106) through non-pharmaceutical (107-109) and pharmaceutical measures (27, 31) should be available at any time during the dying process and at any location [in the delivery room (29), in the neonatal intensive care unit, in the children's hospice, or at home]. Symptom-relieving medication can be administered via existing superficial, central or indwelling intravenous catheters, as well as orally, nasally, rectally, or transdermally.…”

Ethical, Legal, and Religious Aspects at the Border of Viability

“…In the field of neonatology, the basis of ethical deliberations is the recognition that a child is an individual human being from birth (34). It is endowed with the right to life as well as the right to health protection and healthcare provision.…”

The Path Is Made by Walking—Mapping the Healthcare Pathways of Parents Continuing Pregnancy after a Severe Life-Limiting Fetal Diagnosis: A Qualitative Interview Study

“…The increased use of prenatal diagnostics has led to a growing number of diagnoses of life-limiting fetal conditions [ 1 , 2 , 3 ]. Learning about a severe fetal condition is devastating and traumatic [ 4 , 5 , 6 , 7 , 8 , 9 , 10 ].…”

“…In Germany, mothers who receive the diagnosis of a serious fetal condition are entitled to obtain cost-free medical and psychosocial counseling [ 8 , 33 , 34 ]. In most cases, medical counseling is provided by prenatal diagnostic physicians [ 2 , 8 ]. Physicians must inform pregnant women about the option of psychosocial counseling [ 2 , 8 , 10 , 33 , 34 ].…”