Clinical concepts of futility and ethically justified limits on neonatal care: a case presentation of an infant with Apgar scores of 0 at 1, 5, and 10 minutes.
Appropriate length of delivery room resuscitative efforts for infants born without signs of life is controversial. We present the case of a preterm infant with Apgar scores of 0 at 1, 5, and 10 minutes but with a recovered heartbeat at 15 minutes. Using the clinically relevant conceptions of the principle of futility, we examine the ethical justification for the successive decisions to initiate, continue, and ultimately limit care for this patient. This difficult case highlights the importance of understanding the ethical justification for clinical interventions that are made in the neonatal intensive care unit.
Division of Newborn Medicine, New York Presbyterian Hospital, Weill Cornell Medical Center, 525 East 68th Street, New York, NY 10021, USA.
Melanie P
MP
McGraw
Jeffrey
J
Perlman
Frank A
FA
Chervenak
Laurence B
LB
McCullough
D001034:Apgar Score; D004992:Ethics, Medical; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D015931:Intensive Care, Neonatal / Q000941:ethics* / Q000379:methods; D008297:Male; D018447:Medical Futility / Q000941:ethics*; D009519:New York City; D011247:Pregnancy; D012151:Resuscitation / Q000941:ethics* / Q000379:methods