| Title | End-of-life decisions in Dutch neonatal intensive care units. | | Author(s) | Verhagen AA, Dorscheidt JH, Engels B, Hubben JH, Sauer PJ | | Institution | Department of Pediatrics, University Medical Centre, 9700 RB Groningen, the Netherlands. e.verhagen@bkk.umcg.nl | | Source | Arch Pediatr Adolesc Med 2009 Oct; 163(10):895-901. | | MeSH | Cause of Death
Decision Making
Euthanasia
Female
Humans
Infant, Newborn
Infant, Newborn, Diseases
Intensive Care Units, Neonatal
Male
Netherlands
Physician's Practice Patterns
Prognosis
Quality of Life
Retrospective Studies
Withholding Treatment
| | Abstract | OBJECTIVE: To clarify the practice of end-of-life decision making in severely ill newborns.
DESIGN: Retrospective descriptive study with face-to-face interviews.
SETTING: The 10 neonatal intensive care units in the Netherlands from October 2005 to September 2006.
PATIENTS: All 367 newborn infants who died in the first 2 months of life in Dutch neonatal intensive care units. Adequate documentation was available in 359 deaths.
OUTCOME MEASURES: Presence of end-of-life decisions, classification of deaths in 3 groups, and physicians' considerations leading to end-of-life decisions.
RESULTS: An end-of-life decision preceded death in 95% of cases, and in 5% treatment was continued until death. Of all of the deaths, 58% were classified as having no chance of survival and 42% were stabilized newborns with poor prognoses. Withdrawal of life-sustaining therapy was the main mode of death in both groups. One case of deliberate ending of life was found. In 92% of newborns with poor prognoses, end-of-life decisions were based on patients' future quality of life and mainly concerned future suffering. Considerations regarding the infant's present state were made in 44% of infants.
CONCLUSIONS: Virtually all deaths in Dutch neonatal intensive care units are preceded by the decision to withdraw life-sustaining treatment and many decisions are based on future quality of life. The decision to deliberately end the life of a newborn may occur less frequently than was previously assumed. | | Language | eng | | Pub Type(s) | Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
| | PubMed ID | 19805707 |
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