Medical end-of-life decisions in neonates and infants in Flanders.
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| Title: | Medical end-of-life decisions in neonates and infants in Flanders. |
|---|---|
| Authors: | Provost, Veerle, Cools, Filip, Mortier, Freddy, Bilsen, Johan, Ramet, José, Vanderplas, Yvan, Deliens, Luc |
| Source: | Lancet. 4/9/2005, Vol. 365 Issue 9467, p1315-1320. 6p. 5 Charts. |
| Subjects: | Terminal care ethics, Neonatal death, Critical care medicine, Right to die policy, Medical care laws, Life support systems in critical care |
| Abstract: | Background: Paediatricians are increasingly confronted with end-of-life decisions in critically ill neonates and infants. Little is known about the frequency and characteristics of end-of-life decisions in this population, nor about the relation with clinical and patients' characteristics. Methods: A death-certificate study was done for all deaths of neonates and infants in the whole of Flanders over a 12-month period (August, 1999, to July, 2000). We sent an anonymous questionnaire by mail to the attending physician for each of the 292 children who died under the age of 1 year. Information on patients was obtained from national registers. An attitude study was done for all physicians who attended at least one death during the study period. Findings: 253 (87%) of the 292 questionnaires were returned, and 121 (69%) of the 175 physicians involved completed the attitude questions. An end-of-life decision was possible in 194 (77%; 95% CI 70.4-82.4) of the 253 deaths studied, and such a decision was made in 143 cases (57%; 48.9-64.0). Lethal drugs were administered in 15 cases among 117 early neonatal deaths and in two cases among 77 later deaths (13% vs 3%; p=0.018). The attitude study showed that 95 (79%; 70.1-85.5) of the 121 physicians thought that their professional duty sometimes includes the prevention of unnecessary suffering by hastening death and 69 (58%; 48.1-66.5) of 120 supported legalization of life termination in some cases. Interpretation: Death of neonates and infants is commonly preceded by an end-of-life decision. The type of decision varied substantially according to the age of the child. Most physicians favour legalization of the use of lethal drugs in some cases. [ABSTRACT FROM AUTHOR] |
| Copyright of Lancet is the property of Lancet and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
| FullText | Links: – Type: pdflink Text: Availability: 0 |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 16693131 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Medical end-of-life decisions in neonates and infants in Flanders. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Provost%2C+Veerle%22">Provost, Veerle</searchLink><br /><searchLink fieldCode="AR" term="%22Cools%2C+Filip%22">Cools, Filip</searchLink><br /><searchLink fieldCode="AR" term="%22Mortier%2C+Freddy%22">Mortier, Freddy</searchLink><br /><searchLink fieldCode="AR" term="%22Bilsen%2C+Johan%22">Bilsen, Johan</searchLink><br /><searchLink fieldCode="AR" term="%22Ramet%2C+José%22">Ramet, José</searchLink><br /><searchLink fieldCode="AR" term="%22Vanderplas%2C+Yvan%22">Vanderplas, Yvan</searchLink><br /><searchLink fieldCode="AR" term="%22Deliens%2C+Luc%22">Deliens, Luc</searchLink> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Lancet%22">Lancet</searchLink>. 4/9/2005, Vol. 365 Issue 9467, p1315-1320. 6p. 5 Charts. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Terminal+care+ethics%22">Terminal care ethics</searchLink><br /><searchLink fieldCode="DE" term="%22Neonatal+death%22">Neonatal death</searchLink><br /><searchLink fieldCode="DE" term="%22Critical+care+medicine%22">Critical care medicine</searchLink><br /><searchLink fieldCode="DE" term="%22Right+to+die+policy%22">Right to die policy</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+care+laws%22">Medical care laws</searchLink><br /><searchLink fieldCode="DE" term="%22Life+support+systems+in+critical+care%22">Life support systems in critical care</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Background: Paediatricians are increasingly confronted with end-of-life decisions in critically ill neonates and infants. Little is known about the frequency and characteristics of end-of-life decisions in this population, nor about the relation with clinical and patients' characteristics. Methods: A death-certificate study was done for all deaths of neonates and infants in the whole of Flanders over a 12-month period (August, 1999, to July, 2000). We sent an anonymous questionnaire by mail to the attending physician for each of the 292 children who died under the age of 1 year. Information on patients was obtained from national registers. An attitude study was done for all physicians who attended at least one death during the study period. Findings: 253 (87%) of the 292 questionnaires were returned, and 121 (69%) of the 175 physicians involved completed the attitude questions. An end-of-life decision was possible in 194 (77%; 95% CI 70.4-82.4) of the 253 deaths studied, and such a decision was made in 143 cases (57%; 48.9-64.0). Lethal drugs were administered in 15 cases among 117 early neonatal deaths and in two cases among 77 later deaths (13% vs 3%; p=0.018). The attitude study showed that 95 (79%; 70.1-85.5) of the 121 physicians thought that their professional duty sometimes includes the prevention of unnecessary suffering by hastening death and 69 (58%; 48.1-66.5) of 120 supported legalization of life termination in some cases. Interpretation: Death of neonates and infants is commonly preceded by an end-of-life decision. The type of decision varied substantially according to the age of the child. Most physicians favour legalization of the use of lethal drugs in some cases. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Lancet is the property of Lancet and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1016/S0140-6736(05)61028-8 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 6 StartPage: 1315 Subjects: – SubjectFull: Terminal care ethics Type: general – SubjectFull: Neonatal death Type: general – SubjectFull: Critical care medicine Type: general – SubjectFull: Right to die policy Type: general – SubjectFull: Medical care laws Type: general – SubjectFull: Life support systems in critical care Type: general Titles: – TitleFull: Medical end-of-life decisions in neonates and infants in Flanders. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Provost, Veerle – PersonEntity: Name: NameFull: Cools, Filip – PersonEntity: Name: NameFull: Mortier, Freddy – PersonEntity: Name: NameFull: Bilsen, Johan – PersonEntity: Name: NameFull: Ramet, José – PersonEntity: Name: NameFull: Vanderplas, Yvan – PersonEntity: Name: NameFull: Deliens, Luc IsPartOfRelationships: – BibEntity: Dates: – D: 09 M: 04 Text: 4/9/2005 Type: published Y: 2005 Identifiers: – Type: issn-print Value: 01406736 Numbering: – Type: volume Value: 365 – Type: issue Value: 9467 Titles: – TitleFull: Lancet Type: main |
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