[Attitudes towards treatment of extremely premature infants in Norwegian obstetric and pediatric departments].
The aim of this questionnaire survey was to investigate whether Norwegian hospitals have guidelines for lifesaving treatment in cases of extreme prematurity and severe morbidity. 66 out of 71 doctors in charge of Norwegian obstetric and paediatric units answered our questionnaire. 79% of the units had guidelines for starting medical treatment, 45% for ending treatment. Gestational age and the infant's vitality were the most important criteria in decisions concerning withholding of treatment. Two out of three units (44) had a lower gestational age limit, varying from 23 to 25 weeks; 41 of these 44 units used 23 or 24 weeks as the lower limit. Disability risk and the infants' suffering were the most important criteria for termination of treatment. One in five respondents attached little or no emphasis on the infants' suffering. Half of the respondents reported that they felt that making life or death decisions for premature infants had become more difficult over the last few years. Unrealistic expectations and pressure from the media and from parents were important reasons for this. We conclude equality of treatment for premature infants calls for an examination of all factors, medical and psychosocial, with a bearing on decisions.
Kvestad
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Det medisinske fakultet Universitetet i Oslo.
Lunde
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Markestad
T J
TJ
Førde
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R
D001291:Attitude of Health Personnel; D003657:Decision Making; D005865:Gestational Age; D017408:Guidelines as Topic; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000628:therapy*; D019102:Infant, Very Low Birth Weight; D015931:Intensive Care, Neonatal / Q000523:psychology*; D008020:Life Support Care / Q000523:psychology*; D009664:Norway; D009775:Obstetrics and Gynecology Department, Hospital; D010820:Physicians / Q000523:psychology*; D011379:Prognosis; D012307:Risk Factors; D011795:Surveys and Questionnaires