[End-of-life decisions and reluctant treatment of newborns on the borderline of viability in the Netherlands].
End-of-life decisions are taken in the majority of deaths below one year of age, especially in neonatal intensive-care units. In the Netherlands, the frequency of such decisions has not increased in recent years. Intentional termination of life occurred in 1% of the deaths, which would be about 10 cases each year. However, only 3 such cases are reported to the public prosecutor for review by the responsible physician. Proposals from the government to facilitate reporting of such cases are awaited. Dutch neonatologists are reluctant to administer full neonatal intensive care to extremely preterm infants. Currently, the policy regarding antenatal referral and treatment of extremely preterm infants is being re-evaluated by obstetricians and neonatologists. Behind the stable frequency of end-of-life decisions, difficult ethical issues remain to be solved.
Kollée
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LA
Universitair Medisch Centrum St Radboud, Universitair Kinderziekenhuis, Postbus 9101, 6500 HB Nijmegen. l.kollee@cukz.umcn.nl
D001291:Attitude of Health Personnel; D003657:Decision Making / Q000941:ethics; D028601:Euthanasia, Active / Q000941:ethics; D005066:Euthanasia, Passive / Q000941:ethics*; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000941:ethics; D009426:Netherlands; D011379:Prognosis; D028761:Withholding Treatment / Q000941:ethics