Abstract
There are no universally agreed rules of healthcare ethics. Ethical decisions and standards tend to be linked to professional codes of practice when dealing with complex issues. This paper aims to explore the ethical complexities on who should decide to give infants born on the borderline of viability lifesaving treatment, parents or the healthcare professionals. The paper is a discussion using the principles of ethics, professional codes of practice from the UK, Nursing Midwifery Council and UK legal case law and statute. Healthcare professionals' experiences that influence parental decision are also considered. There are considerable barriers to an effective discussion taking place in an environment where clinical decisions have to be made quickly once the baby is born. This is compounded by the need and respect for parental autonomy and the difficulties they face when making a best interest's decision knowing that this could cause more harm than good for their infant child and balancing any decision they make with quality of life. On deciding whether to give lifesaving treatment born at the borderline of viability, it should be a joint decision between the parents and the neonatal team.
Highlights
There are no universally agreed rules of health care ethics
This paper is relevant to any health care professional who is involved in the joint decision making with parents in whether to commence life-saving treatment of a baby born at the verge of viability
Using United Kingdom (UK) case law and statute, this paper aims to explore some of the ethical, professional and legal dilemmas encountered, and will draw on literature from western culture to explore who should decide whether infants born on the verge of viability should be given lifesaving treatment
Summary
There are no universally agreed rules of health care ethics. Ethical decisions and standards tend to be linked to professional codes of practice. Using United Kingdom (UK) case law and statute, this paper aims to explore some of the ethical, professional and legal dilemmas encountered, and will draw on literature from western culture to explore who should decide whether infants born on the verge of viability should be given lifesaving treatment In this context, the term ‘lifesaving treatment’ refers to resuscitation at birth, and the subsequent intensive care treatment which the infant is likely to require in order to survive. Given that once a baby is born, and is considered legally a person that is entitled to the protection of the law with its own human rights, when babies are born on the verge of viability, this marks the outset of a huge ethical debate for families and professionals alike In this arises if all of the risks associated with treatment and the long term detriment to quality of life are known and taken into consideration. They are unable to give consent, nor exercise their right of autonomy.[8]
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