Extremely Preterm Babies—Legal Aspects and Palliative Care at the Border of Viability
Abstract
:1. Introduction
1.1. Legal Aspects
1.2. Conflicts
1.2.1. There Is No Time to Care for Informed Consent
1.2.2. Physicians Want to Start Therapy, Parents Refuse to Agree, Partly Because of Seeing a Long-Term Morbidity and Suffering of the Child
1.2.3. Physicians Cannot Offer a Therapy and Prefer Palliative Care, Nevertheless, Parents Ask for Maximal Therapy
2. Perspectives and Conclusions
Funding
Institutional Review Board Statement
Informed Consent Statement
Acknowledgments
Conflicts of Interest
References
- Lui, K.; Bajuk, B.; Foster, K.; Gaston, A.; Kent, A.; Sinn, J.; Spence, K.; Fischer, W.; Henderson-Smart, D. Perinatal care at the borderlines of viability: A consensus statement based on a NSW and ACT consensus workshop. Med. J. Aust. 2006, 185, 495–500. [Google Scholar] [CrossRef] [PubMed]
- Wilkinson, A.R.; Ahluwalia, J.; Cole, A.; Crawford, D.; Fyle, J.; Gordon, A.; Moorcraft, J.; Pollard, T.; Roberts, T. Management of babies born extremely preterm at less than 26 weeks of gestation: A framework for clinical practice at the time of birth. Arch. Dis. Child. Fetal Neonatal Ed. 2009, 94, F2–F5. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Guillen, Ú.; DeMauro, S.; Ma, L.; Zupancic, J.; Wang, E.; Gafni, A.; Kirpalani, H. Survival rates in extremely low birthweight infants depend on the denominator: Avoiding potential bias by specifying denominators. Am. J. Obstet. Gynecol. 2011, 205, 329.e1–329.e7. [Google Scholar] [CrossRef] [PubMed]
- Berger, T.M.; Bernet, V.; El Alama, S.; Fauchère, J.C.; Hösli, I.; Irion, O.; Kind, C.; Latal, B.; Nelle, M.; Pfister, R.E.; et al. Perinatal care at the limit of viability between 22 and 26 completed weeks of gestation in Switzerland. Revision of the Swiss recommendations. Swiss Med. Wkly 2011, 141, w13280. [Google Scholar] [PubMed]
- Itabashi, K.; Horiuchi, T.; Kusuda, S.; Kabe, K.; Itani, Y.; Nakamura, T.; Fujimura, M.; Matsuo, M. Mortality rates for extremely low birth weight infants born in Japan in 2005. Pediatrics 2009, 123, 445–450. [Google Scholar] [CrossRef] [PubMed]
- Batton, D.G.; DeWitte, D.B.; Pryce, C.J. One hundred consecutive infants born at 23 weeks and resuscitated. Am. J. Perinatol. 2011, 28, 299–304. [Google Scholar] [CrossRef] [PubMed]
- El-Metwally, D.; Vohr, B.; Tucker, R. Survival and neonatal morbidity at the limits of viability in the mid 1990s: 22 to 25 weeks. J. Pediatr. 2000, 137, 616–622. [Google Scholar] [CrossRef] [PubMed]
- Marlow, N. Interpreting regional differences in neonatal outcomes for extremely preterm babies. Acta Paediatr. 2014, 103, 4–5. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Dupont-Thibodeau, A.; Barrington, K.J.; Farlow, B.; Janvier, A. End-of-life decisions for extremely low-gestational-age infants: Why simple rules for complicated decisions should be avoided. Semin. Perinatol. 2014, 38, 31–37. [Google Scholar] [CrossRef] [PubMed]
- Rosner, F. Modern Medicine and Jewish Law; Yeshiva University Press: New York, NY, USA, 1991. [Google Scholar]
- Pohlandt, F. Frühgeburt an der Grenze der Lebensfähigkeit des Kindes. AWMF-Leitlinienregister Nr. 024-019. Z. Geburtsh. Neonatol. 2008, 212, 109–113. [Google Scholar] [CrossRef] [PubMed]
- Pignotti, M.S.; Donzelli, G. Perinatal care at the border of viability: An international comparison of practical guidelines for the treatment of extremely preterm births. Pediatrics 2008, 121, e193–e198. [Google Scholar] [CrossRef] [PubMed]
- Lipp, V.; Brauer, D. Behandlungsbegrenzung und “futility” aus rechtlicher Sicht. Z. Palliativmed. 2013, 14, 121–126. [Google Scholar] [CrossRef]
- UN-Convention on the Rights of the Child–CRC, Official Federal Law Gazette, Germany. 1992; II, 121–144.
- Bührer, C.; Felderhoff-Müsener, U.; Kribs, A.; Roll, C.; Völkner, A.; Gembruch, U.; Hecher, K.; Kainer, F.; Maier, R.F.; Vetter, K.; et al. Frühgeborene an der Grenze der Lebensfähigkeit. Gemeinsame Empfehlung der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe, Deutschen Gesellschaft für Kinder-und Jugendmedizin, Deutschen Gesellschaft für Perinatale Medizin, Akademie für Ethik in der Medizin, Gesellschaft für Neonatologie und Pädiatrische Intensivmedizin unter Mitwirkung des Deutschen Hebammenverbandes und des Bundesverbandes “Das frühgeborene Kind”. Z. Geburtsh. Neonatol. 2015, 219, 12–19. [Google Scholar]
- § 630 D, German Civil Code, Federal Law Official Gazette. 2013; I, 277.
- Boyle, D.; Carlo, W.A.; Goldsmith, J.; Halamek, L.; Perlman, J.; Wiswell, T.E.; Kattwinkel, J.; Engle, W.; González, J.L.; Singhal, N.; et al. Born-alive infants protection act of 2001, Public Law No. 107–207. Pediatrics 2003, 111, 680–681. [Google Scholar] [CrossRef] [PubMed]
- District Court Cologne, Germany (2012) 25 O 424/10.
- Singh, J.; Fanaroff, J.; Andrews, B.; Caldarelli, L.; Lagatta, J.; Plesha-Troyke, S.; Lantos, J.; Meadow, W. Resuscitation in the “gray zone” of viability: Determining physician preferences and predicting infant outcomes. Pediatrics 2007, 120, 519–526. [Google Scholar] [CrossRef] [PubMed]
- Guillén, U.; Weiss, E.M.; Munson, D.; Maton, P.; Jeffries, A.; Norman, M.; Naulaers, G.; Mendes, J.; Justo da Silva, L.; Zoban, P.; et al. Guidelines for the Management of Extremely Premature Deliveries: A systematic Review. Pediatrics 2015, 136, 343–350. [Google Scholar] [CrossRef] [PubMed]
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2022 by the author. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Dettmeyer, R. Extremely Preterm Babies—Legal Aspects and Palliative Care at the Border of Viability. Children 2022, 9, 1594. https://doi.org/10.3390/children9101594
Dettmeyer R. Extremely Preterm Babies—Legal Aspects and Palliative Care at the Border of Viability. Children. 2022; 9(10):1594. https://doi.org/10.3390/children9101594
Chicago/Turabian StyleDettmeyer, Reinhard. 2022. "Extremely Preterm Babies—Legal Aspects and Palliative Care at the Border of Viability" Children 9, no. 10: 1594. https://doi.org/10.3390/children9101594