Prenatal Decision-Making at the Limits of Viability: A Qualitative Examination of Neonatologists’ Consultation Practices
Ethics Grand Rounds:
When delivery of an extremely premature baby is anticipated at 22 to 24 weeks of gestation, the standard of care is for a specialist in Neonatology to consult with families to determine family-centered goals of care to best determine whether to provide intensive resuscitation or comfort measures only for the baby at time of birth. Research demonstrates highly variable approaches to counseling practices across institutions. This talk highlights existing knowledge regarding shared decision-making in this setting. Further, it describes a qualitative study aimed at understanding the mechanics and substance of these consultations in order to develop more effective strategies for individualized and family-centered decision-making.
Chris Collura, MD, MA, Neonatology, Pediatric Palliative Care, Bioethics, Mayo Clinic Children’s Center