Ethics and the Law: Practical Applications in the Neonatal Intensive Care Unit

Abstract

Neonatologists may be unfamiliar with the many legal precedents and federal, state, and local laws that may affect medical practice in the United States. Knowledge of specific laws and court cases pertinent to neonatology is essential for medical practice, particularly in today’s increasingly litigious environment. This article reviews several federal and state laws applicable to neonatology and relevant legal cases that involve neonates that have led to the creation of case law in certain states. Two ethically challenging cases are presented and discussed as theoretical examples of how relevant law and court cases may be applied to neonatal practice. Topics include the attempted resuscitation of an infant or withdrawal of life-sustaining interventions despite parental objection, the right of infants to receive appropriate medical therapy in the emergency department and elsewhere in the hospital (regardless of congenital anomalies or prematurity), and difficulties providing end-of-life care to infants.