Ethical issues in neonatal paediatrics--the Singapore perspective.
In Singapore, formulating ethical guidelines for people who live in a multiracial, multilingual, multicultural and multi-religious community can be difficult. The "individualised prognostic" strategy in the management of critically ill infants has been followed. Our neonatal paediatricians encounter the following ethical problems: extremely premature babies whose viability is doubtful, babies born with severe congenital malformations, babies born with signs of life in legal or therapeutic termination of pregnancy, the asphyxiated babies or babies with severe or extensive brain damage, and babies who are chronically sick and have no chance of recovery or leaving the hospital. Good ethical decisions require medical facts. The infant's diagnosis and prognosis must be accurate. There should also be detailed information that continuation of any form of medical treatment for the infant is futile, will do more harm than good and is inhumane. Ethical decisions should be made in the best interests of the infant. Dating of the infant's gestational age should be accurate and reliable, and there should also be unanimous definitions such as fetal viability, abortions and lethal malformations. Ethical guidelines and the law must also keep pace with changes in medical practice.
Ho
N K
NK
Department of Neonatal Medicine I, Kandang Kerbau Hospital, Singapore.
D000029:Abortion, Legal; D000032:Abortion, Therapeutic; D001238:Asphyxia Neonatorum; D001925:Brain Damage, Chronic; D002908:Chronic Disease; D000013:Congenital Abnormalities; D016638:Critical Illness; D003657:Decision Making; D004992:Ethics, Medical; D005006:Ethnicity; D005260:Female; D005328:Fetal Viability; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D018447:Medical Futility; D010372:Pediatrics; D011247:Pregnancy; D011379:Prognosis; D012846:Singapore