[Ethical features related to clinical decisions in neonatology. Preliminary study].
BACKGROUND
Personnel working in neonatal intensive care units frequently face difficult ethical problems related to the initiation, maintenance or withdrawal of life support therapies.


OBJECTIVE
To assess the importance of ethical issues in the clinical decision making of health care providers in neonatal intensive care units.


METHODS
A questionnaire based on five clinical vignettes that assessed judgments about quality of life, impact of parent's opinions and decision making in emergency situations and with different degrees of certainty, was designed. Eleven neonatologists and 20 nurses and midwives specialized in neonatology anonymously answered this questionnaire.


RESULTS
There was a great inter individual variability in therapeutic approaches in cases with a bad vital and neurological prognosis. In cases of medical emergencies with uncertain diagnoses, bad vital prognosis but neurological indemnity, most professionals coincided in delivering all possible therapeutic options. Parent's opinions had a great impact in medical decisions, except when there was neurological indemnity.


CONCLUSIONS
The specific responsibilities of the different agents in medical decision making must be delimited. Parents do not have absolute rights over their offspring and physicians must reject useless therapies.
Bórquez
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Servicio de Neonatología, Clínica Hospital del Profesor, Escuela de Medicina, Pontificia Universidad Católica de Chile.
Lavados
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M
D004992:Ethics, Medical; D006801:Humans; D007231:Infant, Newborn; D010818:Practice Patterns, Physicians' / Q000592:standards; D011368:Professional-Family Relations; D011379:Prognosis
Aspectos éticos relacionados con las decisiones clínicas en neonatología. Estudio preliminar.