European Journal of Pediatrics

, Volume 155, Issue 9, pp 783–786 | Cite as

Staff attitudes towards continuation of life-support in newborns with major congenital anomalies

  • F. W. J. Hazebroek
  • R. M. M. Smeets
  • A. P. Bos
  • C. Ouwens
  • D. Tibboel
  • J. C. Molenaar
Intensive Care Medicine



This study was conducted to gain insight into the attitudes of medical staff towards life-support of newborns with life-threatening problems, seen against the background of these children's expected morbidity and quality of life. The opinions about the mode of life-support were determined by questonnaires and the demographic characteristics of the respondents were noted. Each patient's risk of mortality was scored by means of the standardized Paediatric Risk of Mortality Score (PRISM). Attitudes towards support were unanimous for 39 of the 46 patients. For the other 7 patients at least one of the respondents preferred a different support mode than that given at the time. The attitudes were influenced by the patient's risk of mortality.


Decisions about lifesupport of newborns with life-threatening problems should include all the disciplines involved in patient care and should be made at an early stage.

Key words

Ethics, medical Intensive care, neonatal Lifesupport care Attitude of health personnel Quality of life 



paediatric risk of mortality


intensive care unit


cardiopulmonary resuscitation


senior intensive care specialist


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Anonymous (1990) Consensus report on the ethics of foregoing life-sustaining treatments in the critically ill. Crit Care Med 18:1435–1439Google Scholar
  2. 2.
    Crisham P (1981) Measuring moral judgement in nursing dilemmas. Nurs Res 30:104–110PubMedGoogle Scholar
  3. 3.
    Farrell PM, Fost NC (1989) Long-term mechanical ventilation in pediatric respiratory failure: medical and ethical considerations. Am Rev Respir Dis 140:S36-S40PubMedGoogle Scholar
  4. 4.
    Gemke RJBJ, Bonsel GJ, Vught AJ van (1994) Effectiveness and efficiency of a Dutch pediatric intensive care unit: validity and application of the pediatric risk of mortality (PRISM) score. Crit Care Med 22:1477–1484PubMedGoogle Scholar
  5. 5.
    Hazebroek FWJ, Tibboel D, Mourik M, Bos AP, Molenaar JC (1993) Withholding and withdrawal of life support from surgical neonates with life-threatening congenital anomalies. J Pediatr Surg 28:1093–1097PubMedGoogle Scholar
  6. 6.
    Kyff J, Puri VK, Rajeha R, Ireland T (1987) Cardiopulmonary resuscitation in hospitalized patients: continuing problems of decision-making. Crit Care Med 15:41–43.11PubMedGoogle Scholar
  7. 7.
    Marshall RE, Kasman C (1980) Burnout in the neonatal intensive care unit. Pediatrics 65:1161–1165PubMedGoogle Scholar
  8. 8.
    Pollack MM, Wilkinson JD, Glass NC (1987) Long-stay paediatric intensive care patients: outcome and resource utilization. Pediatrics 8:855–860Google Scholar
  9. 9.
    Pollack MM, Ruttimann UE, Getson PR (1988) Pediatric risk of mortality (PRISM) score. Crit Care Med 16: 1110–1116PubMedGoogle Scholar
  10. 10.
    Sauer PJJ (1992) Ethical decisions in neonatal intensive care units: the Dutch experience. Pediatrics 90:729–731PubMedGoogle Scholar
  11. 11.
    Visser HKA, Aartsen HGM, Beaufort ID de (1992) Medical decisions concerning the end of life in children in The Netherlands. Am J Dis Child 146: 1429–1431PubMedGoogle Scholar
  12. 12.
    Younger S, Jackson DL, Allen M (1979) Staff attitudes towards the care of the critically ill in the medical intensive care unit. Crit Care Med 7:35–40PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • F. W. J. Hazebroek
    • 1
  • R. M. M. Smeets
    • 1
  • A. P. Bos
    • 2
  • C. Ouwens
    • 1
  • D. Tibboel
    • 1
  • J. C. Molenaar
    • 1
  1. 1.Department of Paediatric SurgerySophia Children's HospitalRotterdamThe Netherlands
  2. 2.Department of Paediatrics, Paediatric Intensive Care Unit, Beatrix ClinicAcademic Hospital GroningenGroningenThe Netherlands

Personalised recommendations