Life-sustaining support: ethical, cultural, and spiritual conflicts part I: Family support--a neonatal case study.
As medical knowledge and technology continue to increase, so will types of life-sustaining support as well as the public's expectations for use of this support with positive outcomes. Health care professionals will continue to be challenged by the issues surrounding the appropriate use of life-sustaining support and the issues it raises. This is especially apparent in the NICU. When parents' belief systems challenge the health care team's ethical commitment to beneficence and nonmaleficence, a shared decision-making model based on mutual understanding of and respect for different viewpoints can redirect the focus onto the baby's best interest. This article addresses three questions: 1. How do nonmaleficence, beneficence, and concern about quality of life guide the use of life-sustaining support? 2. To what extent should parental autonomy and spirituality influence treatment decisions? 3. What efforts can the health care team make to support the family?
Stutts
Amy
A
NICU, St. Francis Medical Center, Cape Girardeau, Missouri 63703, USA. astutts@sfsmc.net
Schloemann
Johanna
J
D026686:Beneficence; D003220:Conflict, Psychological; D003466:Cultural Characteristics; D003657:Decision Making; D004993:Ethics, Nursing; D006801:Humans; D007231:Infant, Newborn; D008020:Life Support Care / Q000379:methods*; D008297:Male; D018447:Medical Futility; D017283:Neonatal Nursing / Q000592:standards*; D024802:Nurse's Role; D033282:Parental Consent; D010290:Parents / Q000523:psychology; D011785:Quality Assurance, Health Care; D011788:Quality of Life; D029181:Spirituality