Do Sociocultural Factors Influence Periviability Counseling and Treatment More Than Science? Lessons From Scandinavia.
Document Type
Article
Publication Date
9-2018
Identifier
DOI: 10.1542/peds.2018-0478M
Abstract
All of us (doctors, parents, bioethicists, and health policy makers) think differently about premature infants who require neonatal intensive care than we do about other patients who are critically ill. In most other clinical circumstances, those that involve patients other than premature infants, our first impulse when confronted with a patient in an emergency is to do whatever we can to rescue the patient. We offer life-sustaining treatments first and ask questions later. With extremely premature infants, by contrast, we first ask questions, ponder our options, and try to develop policies about whether it is appropriate to try to save these infants. We wonder aloud whether these tiny patients are even worth saving. In most countries that have NICUs, and in many hospitals, doctors and policy makers have explicitly specified which infants ought to be offered life-sustaining treatment and which should be allowed to die. Regarding the treatment of infants who are born at the borderline of viability, there are markedly distinct approaches in Sweden, Norway, and Denmark. In each country, the prevailing approaches were developed after careful consideration of many factors, including public sentiment, professional preferences, reported outcomes, philosophical factors, and considerations of cost and cost-effectiveness. In this article, we comment on some of these considerations and the soundness of the resulting practice variations.
Journal Title
Pediatrics
Volume
142
Issue
Suppl 1
First Page
600
Last Page
600
MeSH Keywords
Clinical Decision-Making; Counseling; Cross-Cultural Comparison; Fetal Viability; Humans; Infant, Extremely Premature; Infant, Newborn; Intensive Care Units, Neonatal; Intensive Care, Neonatal; Prenatal Diagnosis; Scandinavian and Nordic Countries; Sociological Factors; Treatment Outcome
Keywords
Clinical Decision-Making; Counseling; Cross-Cultural Comparison; Fetal Viability; Humans; Infant, Extremely Premature; Infant, Newborn; Intensive Care Units, Neonatal; Intensive Care, Neonatal; Prenatal Diagnosis; Scandinavian and Nordic Countries; Sociological Factors; Treatment Outcome
Recommended Citation
Lantos JD, Carter B, Garrett J. Do Sociocultural Factors Influence Periviability Counseling and Treatment More Than Science? Lessons From Scandinavia. Pediatrics. 2018;142(Suppl 1):S600-S602. doi:10.1542/peds.2018-0478M
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