[A careful course of action in a conflict regarding useful treatment of a newborn infant with severe brain damage].
In a newborn female infant, it was concluded that severe perinatal asphyxia had caused such extensive cerebral damage that further medical treatment was useless. Based on their religious beliefs, the parents disagreed, despite the fact that the requested second opinions supported the conclusion of the medical staff. Since the parents persisted, a period of inurement was agreed upon during which reanimation would be performed if necessary. After several months, there was no change in the attitude of the parents towards the policy not to reanimate, even though it was clear that there was no improvement whatsoever in the patient's neurological status, while everyone agreed that she showed signs of increased suffering. The decision regarding the determination of a situation in which further medical treatment was useless was re-evaluated carefully. In a legal procedure started by the parents, the judge supported the decision of the attending physicians. In order to prevent the parents from taking their child home, in which case a situation could arise in which she would be deprived of adequate sedation or analgesia, which the attending physicians were obliged to provide, the Dutch Child Protection Council was consulted and the parents were deprived of their parental authority. Ultimately, the patient died suddenly due to respiratory and circulatory arrest without another situation in which reanimation might have been indicated.
van Beek
R H T
RH
AmphiaZiekenhuis, locatie Langendijk, afd. Kindergeneeskunde, Langendijk 75, 4800 RL Breda. rvbeek@amphia.nl
Buiting
H P J
HP
de Haan
F H
FH
van Goudoever
J B
JB
D001925:Brain Damage, Chronic / Q000628:therapy*; D004992:Ethics, Medical; D005066:Euthanasia, Passive / Q000941:ethics / Q000331:legislation & jurisprudence; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D010290:Parents / Q000523:psychology*; D011379:Prognosis; D012068:Religion and Medicine; D012121:Respiration, Artificial; D012720:Severity of Illness Index; D028761:Withholding Treatment / Q000941:ethics / Q000331:legislation & jurisprudence