End of life care in the setting of extreme prematurity - practical challenges and ethical controversies

Dominic Jc Wilkinson; Sophie Bertaud

doi:10.1016/j.siny.2023.101442

End of life care in the setting of extreme prematurity - practical challenges and ethical controversies

Semin Fetal Neonatal Med. 2023 Aug;28(4):101442. doi: 10.1016/j.siny.2023.101442. Epub 2023 Apr 21.

Authors

Dominic Jc Wilkinson¹, Sophie Bertaud²

Affiliations

¹ Oxford Uehiro Centre for Practical Ethics, Faculty of Philosophy, University of Oxford, UK; John Radcliffe Hospital, Oxford, UK; Murdoch Children's Research Institute, Melbourne, Australia; Centre for Biomedical Ethics, National University of Singapore Yong Loo Lin School of Medicine, Singapore. Electronic address: [email protected].
² Oxford Uehiro Centre for Practical Ethics, Faculty of Philosophy, University of Oxford, UK.

Abstract

While the underlying principles are the same, there are differences in practice in end of life decisions and care for extremely preterm infants compared with other newborns and older children. In this paper, we review end of life care for extremely preterm infants in the delivery room and in the neonatal intensive care unit. We identify potential justifications for differences in the end of life care in this population as well as practical and ethical challenges.

Keywords: Decision-making; End of life; Intensive care; Neonatal; Palliative care; Premature infant.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Child
Humans
Infant
Infant, Extremely Premature
Infant, Newborn
Intensive Care Units, Neonatal
Terminal Care*

Grants and funding

203132/Z/16/Z/WT_/Wellcome Trust/United Kingdom