title: Decision-making at the border of viability by means of values clarification: a case study to achieve distinct communication by ordinary language approach.
abstract: We set out to investigate the major obstacles in achieving a sensitive and supportive communication between parents and clinicians in ethical dilemma situations. We focused on discussions in emergency situations by means of values clarification.
  
  
  
  The study population (n=141) covers four samples of clinical staff (n(1)=72) from different specialties and parents of preterm and term infants (n(2)=69). Because of the vulnerability of parents and the virulence of the topic, the descriptive qualitative case study comprises standardized questionnaires and half-standardized interviews. Data were analyzed graphically and statistically, comparing parents and professionals for the justification of acting using values clarification in this context.
  
  
  
  Our study indicated that the use of a critically reconsidered and less personalized language has to be a major goal in the care of preterm infants at the edge of viability. Furthermore we found that acting ethically means making decisions individually by using open-context terms sensitively in consideration of diverging action-guiding principles.
  
  
  
  Decisions in medicine concern different people - experts as well as patients and their representatives. The present study is an attempt to establish more awareness for improved communication, which is a part of professionalism, as well as coping strategies for all involved.
authors.affiliation: Paracelsus Medical School, Salzburg University, Salzburg, Austria. katharina.paulmichl@pmu.ac.at
authors.forename: Katharina
authors.initials: K
authors.lastname: Paulmichl
authors.forename: Erna
authors.initials: E
authors.lastname: Hattinger-Jürgenssen
authors.forename: Barbara
authors.initials: B
authors.lastname: Maier
mesh_terms: D003142:Communication; D003657:Decision Making; D004992:Ethics, Medical; D005260:Female; D005328:Fetal Viability; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007802:Language; D018447:Medical Futility; D009359:Neonatology / Q000941:ethics; D010290:Parents; D011247:Pregnancy; D011379:Prognosis; D012945:Social Values