Moral tensions at the bedside: A survey of neonatal nurses' perceptions of trisomy 18 care.

Document Type

Article

Publication Date

11-2026

Identifier

DOI: 10.1038/s41372-026-02648-3

Abstract

We sought to characterize bedside nurses' perceptions of providing intensive care to patients with trisomy 18 (T18) in a level IV neonatal intensive care unit (NICU). NICU nurses were anonymously surveyed with an electronic, mixed-methods survey. Items included quantitative questions about whether T18 is "incompatible with life," whether interventions should be offered, open-ended free-text questions, and demographic items. Survey results were analyzed with descriptive statistics and thematic analysis. There were 145 responses (response rate 46%). Most (53%) agreed that T18 was "incompatible with life", and 59% felt that this diagnosis should impact interventions offered. Two major themes emerged from 114 free-text responses, including "perceptions of prognosis" and "ethical considerations." Though most nurses believe that T18 is "incompatible with life" and interventions should be restricted, a substantial minority endorse other perspectives. A range of ethical considerations shape nurses' diverse views, suggesting that they are morally rooted and may contribute to ethical distress.

Journal Title

Journal of perinatology : official journal of the California Perinatal Association

Volume

46

Issue

11

First Page

2143

Last Page

2145

MeSH Keywords

Humans; Trisomy 18 Syndrome; Attitude of Health Personnel; Nurses, Neonatal; Female; Intensive Care Units, Neonatal; Infant, Newborn; Surveys and Questionnaires; Ethical Dilemmas; Adult; Male; Neonatal Nursing

PubMed ID

41951800

Keywords

Trisomy 18 Syndrome; Attitude of Health Personnel; Neonatal Nurses; Neonatal Intensive Care Units; Surveys and Questionnaires; Ethical Dilemmas; Neonatal Nursing

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