title: A transdisciplinary approach to the decision-making process in extreme prematurity.
abstract: BACKGROUND
  A wide range of dilemmas encountered in the health domain can be addressed more efficiently by a transdisciplinary approach. The complex context of extreme prematurity, which is raising important challenges for caregivers and parents, warrants such an approach.
  
  
  METHODS
  In the present work, experts from various disciplinary fields, namely biomedical, epidemiology, psychology, ethics, and law, were enrolled to participate in a reflection. Gathering a group of experts could be very demanding, both in terms of time and resources, so we created a web-based discussion forum to facilitate the exchanges. The participants were mandated to solve two questions: "Which parameters should be considered before delivering survival care to a premature baby born at the threshold of viability?" and "Would it be acceptable to give different information to parents according to the sex of the baby considering that outcome differences exist between sexes?"
  
  
  RESULTS
  The discussion forum was performed over a period of nine months and went through three phases: unidisciplinary, interdisciplinary and transdisciplinary, which required extensive discussions and the preparation of several written reports. Those steps were successfully achieved and the participants finally developed a consensual point of view regarding the initial questions. This discussion board also led to a concrete knowledge product, the publication of the popularized results as an electronic book.
  
  
  CONCLUSIONS
  We propose, with our transdisciplinary analysis, a relevant and innovative complement to existing guidelines regarding the decision-making process for premature infants born at the threshold of viability, with an emphasis on the respective responsabilities of the caregivers and the parents.
authors.forename: Marc
authors.initials: M
authors.lastname: Simard
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Gagné
authors.forename: Raymond D
authors.initials: RD
authors.lastname: Lambert
authors.affiliation: Obstetrics, Gynecology & Reproduction, Faculty of Medicine, and Centre de Recherche en Biologie de la Reproduction, Laval University; Centre Hospitalier Universitaire de Québec (CHUQ) Research Center, Rm T-1-49, 2705 Laurier Blvd, Quebec City, QC G1V 4G2, Canada. yves.tremblay@crchul.ulaval.ca.
authors.forename: Yves
authors.initials: Y
authors.lastname: Tremblay
mesh_terms: D017028:Caregivers / Q000523:psychology; D032921:Consensus; D003422:Critical Care / Q000941:ethics*; D003657:Decision Making / Q000941:ethics*; D005260:Female; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D033183:Interdisciplinary Communication; D008297:Male; D010290:Parents / Q000523:psychology; D011247:Pregnancy; D012737:Sex Factors