The ethical context of prematurity is special. Today, many stakeholders are involved in patient care. In addition, parents are better informed and requested that consideration be given to their views in the choice of treatment offered to their child being born premature. In such a situation, several ethical principles come into play, including the central notion of the paramount interest of the child. It should be more important to discover how to reach a consensus decision between the various parties that decide who makes the decision in the context of the birth at the limit of viability. This article offers a description of the steps that can allow a consensus decision.
The ethical context of Prematurity is a special one. Today, patient care Involves Many Players. In addition, parents are better Informed and Be Demand That Their opinions regarded in the therapeutic options available to prematurely born infant Their. Such a position Brings Into Play a number of ethical Principles, Including the central concept of the child's best interest. In the case of a premature infant Viability Whose borderline is, more important new discovery Should Be Placed on how to Achieve Consensus Among the Parties Concerned Than Deciding Who Should make the decisions. The description has proposed this section of the steps That might lead to a consensus decision.
Decades ago, the ethical decision in a medical context belonged only to the medical profession. Today, many health care providers involved in patient care take part in the decision.
Parents are increasingly well informed and made aware as to matters of health and disease. The evolution of social thought, the path to individualism and self-determination recognized in Western societies are not strangers to all the changes that we see when to make a choice for individual health or child. In the context of new forms of treatment have a significant impact on survival of premature babies, parents sometimes feel powerless and are concerned about their responsibility in choosing interventions for their child.
The physician should share decisions, explain and understand his views respectfully, while promoting and respecting the autonomy of parental choice. It should be able to recognize and explain the various components of ethical deliberation, to promote the reconciliation of different views of stakeholders and parents. Ethical conduct is not a decision but a process that led to a consensus to avoid conflict between different decision makers.
AN ISSUE RELATING TO THE COMMUNITY
In 1994, the Canadian Paediatric Society has made recommendations for decisions to be taken according to gestational age, based on broad statistical data. According to these recommendations, at 22 weeks gestation or less, resuscitation is not recommended. Between 23 and 24 weeks of gestation, parents' views should be taken into account in the decision to initiate resuscitation. Over 25 weeks, however, resuscitation is required, even if the parents are otherwise.
In the U.S., questionnaires designed an approach according to gestational age to guide intervention decisions were sent to physicians. These approaches put forward by the medical societies are nevertheless increasingly criticized. American authors recently described a more comprehensive approach, favored in the context of perinatal care in the limit of viability (6).
In general, this dilemma applies to infants under 28 weeks gestation, which represent the minority of births (0.1% to 0.2%). Given the enormous costs associated with the birth of a very large early in a context of limited resources, an ethical choice of society is necessary. Doctors can only answer to this question, as they have done so far. Some authors members of the medical community have addressed this sensitive issue (8.9), but their partial response demonstrates the need for other social bodies engaged in the debate.