The Ethics Of The Infant's Mortality

A baby deserves to experience and witness life’s beauties. If the mother tragically loses her life during childbirth, it is well worth it.

Nurses are faced with ethical dilemmas on a daily basis, each situation being unique and requiring the nurse to set aside their own values and beliefs in order to properly care for their patients. Situations requiring nurses to make an ethical decision are diverse and dynamic; the values set out by the College of Nurses of Ontario code of ethics remains the same. Therefore, all decision based on these vales regardless of the setting and circumstances ensure consistent solutions. The scenario involves a woman who was admitted to the NICU due to complications during her sixth month of pregnancy. The patient indicated that no extraordinary measures should be made to save her baby; she became further detached when the baby developed a bleed

Aiding the death of infants is a much disputed controversy in healthcare. H. Tristram Engelhardt Jr. provides an ethical view that there is a moral duty not to treat an impaired infant when this will only prolong a painful life or would only lead to a painful death. It is these individuals, like Engelhardt, who must defend this position against groups who consider that we have the ability to prolong the lives of impaired infants, thus we are obligated to do so.

Now, medical advances make it possible for even the most severe premature babies to survive. Preterm babies as young as 22 to 23 weeks gestation can survive, but the costs associated with them is high (Kornhauser & Schneiderman, 2010). The higher cost is attributed to the extended hospital stay of micro preemies in Level 3 NICU (Bird, 2014). Level 3 NICU offers a wide range of neonatal services that include special imaging techniques, advanced ventilation

Now, medical advances make it possible for even the most severe premature babies to survive. As in case of Preterm babies as young as 22 to 23 weeks ( Micro preemies), level 3 NICU offers a wide range of neonatal services including special imaging techniques, advanced ventilation procedures, and special surgeries (Bird, 2014). Advanced technology has helped to increase the survival rate for even the most severe preterm babies, but the costs associated with them is high (Kornhauser & Schneiderman, 2010). The average cost for treating the micro preemie has been estimated to be more than $ 2 million (Kornhauser & Schneiderman, 2010). Nevertheless, this projected cost is excluding the cost of treating long term outcomes in the micro preemies. The

The Nuffied Council on Bioethics (2006) report Critical Care Decisions in Fetal and Neonatal Medicine states there are three main ethical issues surrounding neonatal intensive care by both professionals and the public which includes the borderline of viability, fetal medicine and the critical care decision-making for babies receiving intensive care (Teasdale, D. 2007).

One in every ten babies are premature, but what are premature babies? A premature baby is a baby who is not in the mother full term, meaning it was born before the 37th week of pregnancy. A preemie baby's vital organs have not had the necessary final weeks in the womb to develop fully and healthily. Premature births are the leading cause in death in children younger than five.

believe their child's life may have meaning or purpose they do not yet understand. They believe they

In article, Immediate and Delayed Cord Clamping in Infants Born Between 24 and 32 Weeks: A Pilot Randomized Controlled Trial, Mercer reported possible issues regarding methodological assessment of the preceding research involving the capability to perform a meta-analysis of the seven studies. However, a pilot randomized controlled trial (RCT) aggregates on the present day literature on cord clamping by considering the feasibility, recruitment strategies, and key outcomes of the possible increases in blood volume as a result of delayed cord clamping (DCC) (Mercer et al., 2003). In the pilot RCT, Mercer and the team wanted to assess credibility of DCC and the study protocol in the authors’ institution. In addition, they wanted to test and generate hypotheses in order to set up the groundwork for funding for a larger RCT. The first hypothesis stated that DCC in very low-birth-weight (VLBW) infants would have an outcome of higher mean blood pressure after reaching the neonatal intensive care unit (NICU). The second hypothesis stated that VLBW infants would have higher hematocrits, fewer clinical acuity indicated by fewer days of ventilation and fewer days of oxygen use when compared to ICC (Mercer et al., 2003). The focus of the study was to establish feasibility of a protocol for DCC against ICC at preterm birth and, also to inspect its outcomes on initial blood pressure and other events. This kind of study was the first one to observe the outcomes of DCC in

According to the WHO preterm birth complications are the leading cause of death among children under the age of 5, and responsible for nearly 1 million deaths in 2013.1 Many therapies have emerged with advancements in perinatal and neonatal care including antenatal steroids, exogenous surfactants and ventilation advancements that have lead to the rise in the survival of premature infants. However, prematurity is still associated with many morbidities, such as need for prolonged ventilatory support, intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC) and retinopathy of prematurity (ROP). Of these, respiratory distress syndrome (RDS) is the most common cause of morbidity, with an incidence of 42% in infants weighing 501-1500gms.2

Until recently, relatively little research had been carried out in the realm of children’s right to be heard within the healthcare setting. However, in addition to a growing interest in how babies participate in their social and learning relationships, the idea that children are rights bearers rather than objects of concern has been extremely influential . In their paper entitled, ‘The Participation Rights of Premature Babies’, Priscilla Alderson, Joanna Hawthorn and Margaret Killen (Alderson et al. 2005) challenge orthodox opinion that babies are not even persons, let alone bearers of rights (Singer and Kuhse 1985). They explore the perimeters of citizenship and children’s rights by questioning just how far premature babies are recognised

“Approximately 1 of every 200 infants delivered after 22 weeks is stillborn due to lethal abnormalities, cord accidents, infections and other causes. The mortality rate in 2007 in America was 6.75 infant

Ethical decisions and issues in neonatal nursing deem conflicting amongst families and the healthcare team since it is unknown if an infant born severely premature, between 22-24 weeks in gestation at 450g, if survival is imminent. Many advancements in treatment, technology, and healthcare perceive feasible, but when a premature infant’s life is compromised, due to severe prematurity, finding the best possible solutions and treatment options may put the healthcare team, caring for the infant, in a conflicting situation. Survival rates amongst premature newborns and severely ill infants have skyrocketed due to the increased advancement and development in nursing, medicine, and treatment plans. Finding the best possible solutions

Preterm birth is the leading cause of neonatal mortality.1 It is estimated that preterm birth is the direct cause of 29% of deaths in children under 28 days and 11% of deaths in children under 5 years.1–3

In order to give the best available services, these neonatal units need continuous evaluation. Studying outcome of neonates admitted to neonatal units is an important parameter of evaluation. Worldwide, many published studies reported very different outcomes in terms of mortality and morbidity rates (2, 3, 4, 5). This can be explained by different nature of population, different environmental conditions, different study designs, variability in available resources and different patterns of neonatal problems from country to another. Therefore mortality and morbidity figures can not be applied globally and each neonatal unit needs to have its own figures. This helps strategic management planning and redirection of available resources especially in developing countries where resources are very limited.