» Articles » PMID: 35327716

Redirecting Care: Compassionate Management of the Sick or Preterm Neonate at the End of Life

Overview
Specialty Health Services
Date 2022 Mar 25
PMID 35327716
Authors
Affiliations
Soon will be listed here.
Abstract

The primary moral commitment of medical care has traditionally been based on a belief in the intrinsic value and significance of human life and a desire to protect the most vulnerable from harm. In this respect, the care of newborn infants who are at the border of viability is no different. Despite the intrinsic value of the life of every newborn, all agree that there is no moral duty of doctors to provide every possible treatment where the prognosis is hopeless. Instead, every action and treatment should be orientated towards the best interests of the individual child and towards the minimisation of serious harm. Decisions about the withholding or withdrawal of life-supportive treatment should be made collaboratively between professionals and parents, with discussion starting prior to delivery wherever possible. The goals of neonatal palliative care are to prevent or minimise pain and distressing symptoms and to maximise the opportunity for private, loving interaction between the dying baby and his or her parents and the wider family. Physical contact, gentle stroking, cuddles and tender loving care are of central importance for the dying baby. At the same time, we must provide psychological support for parents and family as they go through the profound and painful life experience of accompanying their baby to death. To enable a baby to die well, pain-free and in the arms of loving parents and carers is not a failure but a triumph of neonatal care.

Citing Articles

Redirection of Care for Neonates with Hypoxic-Ischemic Encephalopathy Receiving Therapeutic Hypothermia.

Gubler D, Wenger A, Boos V, Liamlahi R, Hagmann C, Brotschi B J Clin Med. 2025; 14(2).

PMID: 39860326 PMC: 11765625. DOI: 10.3390/jcm14020317.


Social Touch: Its Mirror-like Responses and Implications in Neurological and Psychiatric Diseases.

Grandi L, Bruni S NeuroSci. 2024; 4(2):118-133.

PMID: 39483320 PMC: 11523712. DOI: 10.3390/neurosci4020012.

References
1.
Witt N, Coynor S, Edwards C, Bradshaw H . A Guide to Pain Assessment and Management in the Neonate. Curr Emerg Hosp Med Rep. 2016; 4:1-10. PMC: 4819510. DOI: 10.1007/s40138-016-0089-y. View

2.
Fitzgerald M . What do we really know about newborn infant pain?. Exp Physiol. 2015; 100(12):1451-7. DOI: 10.1113/EP085134. View

3.
Wyatt J . Medical paternalism and the fetus. J Med Ethics. 2001; 27 Suppl 2:ii15-20. PMC: 1765544. DOI: 10.1136/jme.27.suppl_2.ii15. View

4.
Goksan S, Hartley C, Emery F, Cockrill N, Poorun R, Moultrie F . fMRI reveals neural activity overlap between adult and infant pain. Elife. 2015; 4. PMC: 4402596. DOI: 10.7554/eLife.06356. View

5.
Janvier A, Nadeau S, Deschenes M, COUTURE E, Barrington K . Moral distress in the neonatal intensive care unit: caregiver's experience. J Perinatol. 2007; 27(4):203-8. DOI: 10.1038/sj.jp.7211658. View