PL.91 The Ethics Decision Concerning Premature Newborn: Reflections of Doctors and Nurses

Abstract

Background In recent years there has been an increase of birth of premature babies and also in the increased survival of extremely premature with very low birth weight. The process of enabling these newborns requires multiple and complex care that are associated with significant ethical issues. Objective To explore the experience of health professionals on ethical decision making in the care of the premature babies. Methods We conducted a qualitative study of phenomenological nature, in the area of the constructivist paradigm, interviewing 13 doctors and 14 nurses who work in NICUs (Neonatal Intensive Care Units) located in the Centre region of Portugal. Results On the deep discursive reflections, we understood the concerns and conflicts in difficult decision making, given the duty to revive in the limit of viability, the unquestionable respect to the human life and also the ethical duty and morally justified to limit or discontinue care, as response to the criterion of "best interests of the child". We underline some ambiguity surrounding the decision making to withhold treatment in situations of unfavourable prognostic, an understandable attitude ethically grounded in respect for life. They evidenced concerns about dying with dignity, yet there are no standards/recommendations for neonatal palliative care. Conclusions We believe that reflection on practise could help to consolidate a culture of ethics on health professionals who work with premature infants and their parents. We emphasise the importance of protocols and criteria that guide clinical practise regarding these situations.