“Physicians have a moral duty to maintain a therapeutic relationship with their patients in order to sustain a sense of moral community. We submit it is ethically appropriate to allow a mother to retain the informed choice whether to resuscitate her periviable child immediately upon birth when, in conjunction with the physician, the determination of what is in the best interest of the baby is unclear (zone of ambiguity). If she elects the option of no resuscitation, this delivery room hospice approach provides a commonly justified alternative at older ages to standard neonatal‘comfort care’ measures in association with a painless death for her child. If delivery is imminent and aborting in the clinical setting is not a desirable option, we should consider respecting maternal autonomy, by allowing a vaginal delivery with the promise of offering opioids to assuage the dying process in a patient at high risk for lifelong handicap as with any other hospice condition.”
Garbi, Lyndsey R, Shah, Shetal, & La Gamma, Edmund F. (2016). Delivery room hospice. Acta Pædiatrica., 105(11), 1261-1265
Additional resources:
Cortezzo, DonnaMaria E, Marilyn R Sanders, Elizabeth A Brownell, and Kerry Moss. “End-of-life Care in the Neonatal Intensive Care Unit: Experiences of Staff and Parents.” American Journal of Perinatology. 32.8: 713-24.
Full Text Access for Emory Users
Bakhbakhi, D., Burden, C., Storey, C., Heazell, A. E., Lynch, M., Timlin, L., Gold, K., & Siassakos, D. (2019). PARENTS 2 Study: a qualitative study of the views of healthcare professionals and stakeholders on parental engagement in the perinatal mortality review-from ‘bottom of the pile’ to joint learning. BMJ open, 8(11), e023792.
Full Text Access for Emory Users
Marc-Aurele, Krishelle L, & English, Nancy K. (2017). Primary palliative care in neonatal intensive care. Seminars in Perinatology., 41(2), 133-139.
Full Text Access for Emory Users
Ferrell, Betty, Cheryl Ann Thaxton, and Heather Murphy. “Preparing Nurses for Palliative Care in the NICU.” Advances in Neonatal Care : Official Journal of the National Association of Neonatal Nurses. 20.2: 142-50.
Full Text Access for Emory Users
Is This My Home? A Palliative Care Journey Through Life and Death in the NICU: A Case Report. (2020). Advances in Neonatal Care : Official Journal of the National Association of Neonatal Nurses., 20(2), 127.
Full Text Access for Emory Users
Evidence Matters 