Neonatal Care: Legal and Ethical Issues

You are working as an ST2 in a neonatal intensive care unit. You and your consultant are called to the delivery of baby Ayesha, who has just been born at 25 weeks following a normal pregnancy. When you arrive, she is not breathing spontaneously and has a slow heart rate. She is intubated and ventilated and requires a brief period of cardiopulmonary resuscitation. Following this, she is able to be stabilized on the ventilator and is transferred to the neonatal unit. Although she appears reasonably stable over the next 48 hours, a cranial ultrasound scan shows large bleeds into her brain (bilateral grade IV intra-ventricular hemorrhages).

• Was it the correct decision to resuscitate the baby at birth?
• Does this baby have a right to life?
• When parents’ views conflict with doctors’, who decides what treatment is given to a neonate?
• What impact do parents’ religious beliefs have?
• Does the financial cost of continuing intensive care make any difference to what should be done?

Apply Theory (Specific Professional Healthcare Competencies + Clinical Medical Ethical Principles) to Practice in order to provide Optimal Patient-Centered Care (OPCC)

Clinical Ethics and Law, Second edition. Carolyn Johnston, Penelope Bradbury, Series editor: Janice Ryme