title: Treatment choice for infants in the neonatal intensive care unit at risk for AIDS.
abstract: Many infants admitted to neonatal intensive care units are the children of women infected with the human immunodeficiency virus (HIV); they have approximately a 30% risk of infection. To investigate attitudes surrounding treatment for such newborns, we conducted a survey of professionals at six neonatal intensive care units in New York City. A significant proportion of the 247 respondents recommended less aggressive treatment for non-HIV-related conditions for infants at risk for HIV compared with those not at risk. For example, 97% of respondents recommended open heart surgery for an infant with no known HIV risk but only 77% recommended surgery for an infant whose mother had acquired immunodeficiency syndrome; if certain the infant was infected, 42% of respondents recommended surgery. We conclude that perceived HIV status may influence decision making about treatment for non-HIV-related conditions for critically ill patients, including infants not actually infected. Ethical issues concerning the relevance of HIV status need to be examined.
authors.affiliation: Department of Health and Nutrition Sciences, Brooklyn College, NY 11210.
authors.forename: B W
authors.initials: BW
authors.lastname: Levin
authors.forename: J M
authors.initials: JM
authors.lastname: Driscoll
authors.forename: A R
authors.initials: AR
authors.lastname: Fleischman
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000209:etiology*; D001291:Attitude of Health Personnel; D003422:Critical Care / Q000706:statistics & numerical data*; D003657:Decision Making; D028741:Ethics Committees, Clinical; D015658:HIV Infections / Q000209:etiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000628:therapy*; D007363:Intensive Care Units, Neonatal / Q000592:standards*; D009359:Neonatology; D009519:New York City; D018579:Patient Selection; D037841:Pregnant People; D012307:Risk Factors; D011795:Surveys and Questionnaires; D035501:Uncertainty; D028761:Withholding Treatment