Cool heads: ethical issues associated with therapeutic hypothermia for newborns

Abstract

Hypothermia is the first treatment for newborns with hypoxic-ischaemic encephalopathy (HIE) with consistent evidence of a reduction in the risk of death or severe disability. This paper addresses a number of ethical and practical issues faced by clinicians as cooling moves from an experimental treatment into practice. These issues are not unique to therapeutic hypothermia. They include the extrapolation of evidence from trials to clinical care, as well as the impact of hypothermia on prognosis and withdrawal of life-sustaining treatment. Hypothermia is a promising new therapy, but further research will be necessary to help resolve some of the ethical concerns associated with its use in newborns with HIE .