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In the best interest of the. . .parents: Norwegian health personnel on the proper role of parents in neonatal decision-making

Ursin, Lars; Syltern, Janicke Marita
Journal article, Peer reviewed
Published version
Åpne
Ursin (Låst)
Permanent lenke
http://hdl.handle.net/11250/2639779
Utgivelsesdato
2018
Metadata
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Samlinger
  • Institutt for samfunnsmedisin og sykepleie [2408]
  • Publikasjoner fra CRIStin - NTNU [26591]
  • Publikasjoner fra Cristin - St. Olavs hospital [771]
  • St. Olavs hospital [1309]
Originalversjon
Pediatrics. 2018, 142 S567-S573.   10.1542/peds.2018-0478H
Sammendrag
OBJECTIVES: The role of parents in life-and-death decision-making for infants born at the border of viability is challenging. Some argue that parents should have the final say in decisions about life-sustaining treatment. Others disagree. In this article, we report views from health care personnel (HCP) on the appropriate parental role.

METHODS: Focus group interviews with 5 different groups of HCP (neonatal nurses, midwifes, obstetricians, mother-fetal specialists, and neonatologists) dealing with life-and-death decisions throughout pregnancy and birth were performed at the Norwegian University of Science and Technology and at St Olav’s Hospital in Trondheim, Norway in 2014–2017. Interviews were taped and transcribed. Inductive analysis was performed for each group discussion for emergent ethical themes. A summary of the transcribed discussion was sent to the relevant focus group participants for comments.

RESULTS: Our participants felt strongly that doctors, not parents, should have the final say. They did not think parents should have to live with the burden of the decision. The possible disagreement between parents, lack of necessary knowledge, experience, time, and emotional stability all point toward the neonatologist as the optimal decision-maker, within a model of “Patient Preference–Satisfaction Paternalism.”

CONCLUSIONS: The general attitude of our groups was that parents should have a say and be included in a thorough information and decision-making process. The doctor, or a team of HCP, however, should make the final decision, being in the best position both epistemologically and normatively to promote the best interest of both parents and the child.
Utgiver
American Academy of Pediatrics
Tidsskrift
Pediatrics

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