title: Baby O and the Withdrawal of Life-Sustaining Medical Treatment in the Devastated Neonate: A Review of Clinical, Ethical, and Legal Issues.
abstract: The discontinuation of life sustaining medical treatment (LSMT) in severely and permanently impaired neonates, especially artificial nutrition and hydration (ANH) is subject to uncertainty and controversy. Definitive clinical guidelines are lacking, clinical research is limited, ethical disagreement is commonplace, and while case and statutory law provide legal underpinning for the practice in defined circumstances, uncertainty in this realm likely influences clinical practice. We use the case of a neurologically devastated neonate to highlight and review these arenas, and show how, using available legal, ethical, and clinical standards and practice, the case of Baby O was resolved, and to underline the need for further research in neonatal palliative care.
authors.affiliation: 1 Connecticut Hospice, Branford, CT, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Sacco
authors.affiliation: 2 Santa Monica-UCLA Medical Center and Orthopaedic Hospital, Santa Monica, CA, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Virata
mesh_terms: D002985:Clinical Protocols; D006801:Humans; D007231:Infant, Newborn; D008020:Life Support Care / Q000941:ethics* / Q000331:legislation & jurisprudence*; D018529:Nutritional Support / Q000941:ethics; D024382:Professional Role; D028761:Withholding Treatment / Q000941:ethics* / Q000331:legislation & jurisprudence*
keywords: artificial nutrition and hydration; life-sustaining medical treatment; medical ethics; medicolegal; neonatal intensive care unit; neonate; neurologically impaired; withdrawal