title: [Controversy in the treatment of a critically ill neonate in a rural health service].
abstract: Cardiopulmonary resuscitation of newborns with perinatal hypoxia faces serious ethical, moral, medical and legal problems, particularly in rural areas. Ethical and moral issues have to do with the medical-parents relationship; with values, preferences and priorities of each of these groups; and with the scarce resources situation. Medical-technical problems are related to asphyxia complications, and their prognostic and therapeutic implications. Legal considerations arising from the fact of killing or letting die. In this article is analyzed the real case of a neonate with severe perinatal hypoxia in order to enhance the understanding of the incorporation of ethics in everyday clinical practice.
authors.affiliation: Departamento de Cardiopatías Congénitas, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Distrito Federal, México . horaciomarquez84@hotmail.com.
authors.forename: Horacio
authors.initials: H
authors.lastname: Márquez-González
authors.forename: Edith
authors.initials: E
authors.lastname: Valdez-Martínez
mesh_terms: D016638:Critical Illness; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000150:complications / Q000628:therapy*; D007231:Infant, Newborn; D018447:Medical Futility / Q000941:ethics*; D008800:Mexico; D011788:Quality of Life; D012121:Respiration, Artificial / Q000941:ethics; D012151:Resuscitation / Q000941:ethics* / Q000379:methods; D019035:Rural Health Services / Q000941:ethics*; D028761:Withholding Treatment / Q000941:ethics*
keywords: Asphyxia neonatorum; Clinical ethics; Mexico; Newborn infant; Rural health services