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Neonatology pp 183-201 | Cite as

Ethical Problems in Neonatal Medicine

  • Otwin Linderkamp
Reference work entry

Abstract

In perinatal and neonatal medicine, the Hippocratic Oath can be translated into the responsibility of the physicians to act in the “best interests” of the fetus and newborn infant and to avoid harming the fetus and infant and also the mother. This implies that the benefit of treatments should outweigh the harm and risks of the treatment for the patient. The decision-making process is extremely difficult for infants with uncertain prognosis such as extremely preterm infants. The knowledge of long-term outcome is essential for correct and complete antenatal and postnatal counseling of parents and for decision processes in the care of the high risk newborn. Laws and guidelines are necessary and available for care at the limit of viability, but there are different attitudes toward critically ill neonates in different countries, in different centers, and among caregivers in the same center. The decision-making process is articulated in at least three time points: care of mother and fetus before birth, initiation or withholding of resuscitation of the infant after birth, and continuation or withdrawal of neonatal intensive care. Knowledge of newborn and parental rights is the starting point for decisions by physicians from the antenatal until postnatal period.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Neonatology, Department of PediatricsUniversity of HeidelbergHeidelbergGermany

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