The Turkish Journal of Pediatrics
2009 , Vol 51 , Num 3
End-of-life decisions in the newborn period: attitudes and practices of doctors and nurses
Departments of Pediatrics1,Public Health2,Psychiatry, Marmara University Faculty of Medicine, İstanbul, Turkey3,
The aim of our study was to assess the attitudes and practices of doctors
and nurses about end-of-life decisions and compare our results with those
observed in different European countries.
The data was collected from nurses and doctors, using a standardized
questionnaire adapted from the EURONIC study. A total of 250 structured
questionnaires were delivered, and 135 (77%) of them were accepted for
analysis.
The end-of-life decision was taken in 39.4% of the hospitals and personal
involvement was 40%. Although an ethical committee was present in the
hospitals of 61.5% of responders, a written policy was present in only 3.1%
of the units. The mean attitude score was 6.5. Seventy-five percent of the
contributors agreed that everything possible should be done to ensure a
neonate’s survival regardless of the prognosis and 65.2% of responders
believed that costs of health care should not affect nontreatment decisions.
Most of the responders (65.2%) agreed that severe mental disability as an
outcome was equal to or worse than death.
In patients in whom medical intervention would be futile, or would not offer
sufficient benefit to justify the burdens imposed, hospitals should set up a
functional ethical committee in order to decide in matters of withholding or
withdrawing intervention.
Keywords :
end-of-life decision, newborn, euthenasia.