746 A Preliminary Survey: Ethical Decisionmaking for Dying Infants in Nicu in Taiwan

Purpose: The purposes of this study were to explore the decision-making process for dying infants in the neonatal intensive care unit in Taiwan. Methods: A retrospective method was used to review charts of infants who died in the NICU between 2002 and 2008. All research data were reviewed for final admission by a researcher. Results: Sixty-one charts were evaluated in this research. A “do not resuscitate” (DNR) order was considered and written in 41 (67.2%) infants. In seven infants, parents had considered the DNR but no preexisting DNR was entered in the records. Forty-one charts (67.2%) had DNR orders preceding final hospital admission. Eight parents (16%) had allowed discontinuation of ventilator support when they realized the futility of continued care for dying infants. Five infants received a DNR order withholding chest compression but permitting mechanical ventilation. Three infants received a preexisting DNR order withholding chest compression and withdrawing emergency medicines. Three infants received a preexisting DNR order withholding CPR procedures, and withdrawing emergency medicines but permitting ventilator use. Discussion: Although excessively invasive treatment such as intubation is being offered and may well be harmful to dying infants, most parents hesitated making a critical decision for their dying infant in this research. Further research should study humane and compassionate care and the needs of bereaved parents and help them to make decision.