Medical Futility in the Neonatal Intensive Care Unit: Hope for a Resolution
Contemporary medical practice in the NICU sometimes leads to conflicts between providers and parents in which the parent demands continuation of life-sustaining treatment that the medical team deems medically inappropriate or futile. Such conflicts can be difficult to resolve and trying for all part...
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| Veröffentlicht in: | Pediatrics (Evanston) 2005-11, Vol.116 (5), p.1219-1222 |
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| container_title | Pediatrics (Evanston) |
| container_volume | 116 |
| creator | Fine, Robert L Whitfield, Jonathan M Carr, Barbara L Mayo, Thomas W |
| description | Contemporary medical practice in the NICU sometimes leads to conflicts between providers and parents in which the parent demands continuation of life-sustaining treatment that the medical team deems medically inappropriate or futile. Such conflicts can be difficult to resolve and trying for all parties. Here we describe a conflict involving a 25-week-gestation, 825-g newborn with multiple intractable medical problems and resolution of the conflict through ethics consultation under provisions of the Texas Advance Directives Act. The process established under Texas law sets conceptual and temporal boundaries around the problem of medical futility and provides a legal safe harbor for physicians who seek to withdraw life-sustaining treatments in the setting of medical futility, allowing resolution of such conflicts in a timely and effective manner. As such, it may provide a model for physicians in other states to follow. |
| doi_str_mv | 10.1542/peds.2004-2790 |
| format | Article |
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Such conflicts can be difficult to resolve and trying for all parties. Here we describe a conflict involving a 25-week-gestation, 825-g newborn with multiple intractable medical problems and resolution of the conflict through ethics consultation under provisions of the Texas Advance Directives Act. The process established under Texas law sets conceptual and temporal boundaries around the problem of medical futility and provides a legal safe harbor for physicians who seek to withdraw life-sustaining treatments in the setting of medical futility, allowing resolution of such conflicts in a timely and effective manner. 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Whitfield, Jonathan M ; Carr, Barbara L ; Mayo, Thomas W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c539t-64faafff1895e3c997c9dfef1e7eaa497c0780e1e99b8ac8ad7a2d48832492323</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adolescent</topic><topic>Biological and medical sciences</topic><topic>Care and treatment</topic><topic>Case studies</topic><topic>Critical care</topic><topic>Critical Illness</topic><topic>Decision Making</topic><topic>Diseases</topic><topic>Ethics, Medical</topic><topic>Family</topic><topic>Female</topic><topic>General aspects</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Infant, Premature</topic><topic>Infant, Premature, Diseases</topic><topic>Infants (Newborn)</topic><topic>Intensive care nursing</topic><topic>Life Support Care</topic><topic>Life support systems</topic><topic>Male</topic><topic>Medical ethics</topic><topic>Medical Futility</topic><topic>Medical sciences</topic><topic>Methods</topic><topic>Neonatal care</topic><topic>Neonatal diseases</topic><topic>Parents</topic><topic>Pediatrics</topic><topic>Physicians</topic><topic>Practice</topic><topic>Pregnancy</topic><topic>Right to die</topic><topic>Texas</topic><topic>Withholding Treatment</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fine, Robert L</creatorcontrib><creatorcontrib>Whitfield, Jonathan M</creatorcontrib><creatorcontrib>Carr, Barbara L</creatorcontrib><creatorcontrib>Mayo, Thomas W</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: High School</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatrics (Evanston)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fine, Robert L</au><au>Whitfield, Jonathan M</au><au>Carr, Barbara L</au><au>Mayo, Thomas W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Medical Futility in the Neonatal Intensive Care Unit: Hope for a Resolution</atitle><jtitle>Pediatrics (Evanston)</jtitle><addtitle>Pediatrics</addtitle><date>2005-11-01</date><risdate>2005</risdate><volume>116</volume><issue>5</issue><spage>1219</spage><epage>1222</epage><pages>1219-1222</pages><issn>0031-4005</issn><eissn>1098-4275</eissn><coden>PEDIAU</coden><abstract>Contemporary medical practice in the NICU sometimes leads to conflicts between providers and parents in which the parent demands continuation of life-sustaining treatment that the medical team deems medically inappropriate or futile. 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| subjects | Adolescent Biological and medical sciences Care and treatment Case studies Critical care Critical Illness Decision Making Diseases Ethics, Medical Family Female General aspects Humans Infant, Newborn Infant, Premature Infant, Premature, Diseases Infants (Newborn) Intensive care nursing Life Support Care Life support systems Male Medical ethics Medical Futility Medical sciences Methods Neonatal care Neonatal diseases Parents Pediatrics Physicians Practice Pregnancy Right to die Texas Withholding Treatment |
| title | Medical Futility in the Neonatal Intensive Care Unit: Hope for a Resolution |
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