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14 - Decision-making in the delivery room

from Section 2 - Ethical issues at the beginning of life: perinatology and neonatology

Published online by Cambridge University Press:  07 October 2011

By
Mark R. Mercurio
Edited by
Douglas S. Diekema ,
Mark R. Mercurio  and
Mary B. Adam
Douglas S. Diekema
Affiliation:
Seattle Children's Research Institute
Mark R. Mercurio
Affiliation:
Yale University School of Medicine
Mary B. Adam
Affiliation:
Department of Pediatrics, University of Arizona School of Medicine, Tucson
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Summary

Case narrative

A 26-year-old woman is admitted to the Labor and Delivery Unit in early labor. She is at 23 weeks’ gestation (based on last menstrual period and second trimester ultrasound) with a singleton female fetus, and the pregnancy has been unremarkable until today. The estimated fetal weight is 580 grams, and there are no apparent anomalies on the ultrasound done today. The perinatologist believes that the patient will deliver today, and requests that the neonatology team meet with the patient and her husband to discuss the prognosis and the management plan for the baby. Since choices surrounding care of the newborn might also influence obstetrical decisions, the meeting is requested immediately.

Summary of ethical issues

Decisions regarding newborn resuscitation are often made under great time pressure, either due to imminent delivery, thus limiting the time for discussion with the parents beforehand, or because specific actions may be required immediately after delivery if the child is to have a chance at survival. For this reason, it is essential to have considered the possible scenarios that may arise when the child is born and, as much as possible, to have worked through the ethical questions beforehand. There will be very little, if any, opportunity for ethical analysis or in-depth discussion at the time of delivery.

Type
Chapter
Information
Clinical Ethics in Pediatrics
A Case-Based Textbook
 , pp. 77 - 82
Publisher: Cambridge University Press
Print publication year: 2011

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References

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