The chosen topic is on the decisions and dilemmas faced during resuscitation of infants born on the verge of viability. Due to the recent advancements in neonatal care, survival rates and prognosis of prematurely born infants between weeks 22 and 24 of gestation has improved. Before, most of the prematurely born infants would die due to lack of proper care techniques. These gestational ages were considered nonviable at that time. However, the infants can now be discharged to go home and live a healthy life free of morbidities. One of the medical procedures performed to increase survival rates of the preterm infants is resuscitation. Despite its success, there are medical and ethical problems associated with successful resuscitation of severely immature infants. It could lead to increased morbidity or mortality. Therefore, the decision to resuscitate may be complex and full of ethical and medical dilemmas. The decision is further complicated by the lack of a universally agreed-upon standard of practice regarding resuscitation of preterm infants.
The Controversy
Decisions made by neonatal nurses should be within the established ethical principles. At the same time, the nurses should give the best possible care that will improve the health conditions and survival chances for the children. There are four basic ethical principles that lead to such dilemmas. They include autonomy, beneficence, nonmaleficence, and justice.
Delegate your assignment to our experts and they will do the rest.
Autonomy
This principle states that every patient has the right to make important decisions in his/her medical care. The individuals must be sufficiently informed about their conditions, possible consequences, and the possible treatment methods. After being informed about everything they need to know, the final decision should be left with the patients. However, infants are not able to act autonomously meaning they are unable to make the care decisions. Parents become the surrogates charged with the responsibility of making the decisions. The problem is that preterm births are cases of emergencies and unpredictable in most cases. It becomes nearly impossible to inform the parents to make prior analyzed decisions. As a result, the parents may not fully comprehend the gravity and outcome of the incidents and are unable to make the best decisions. While nurses need to act with speed to save time, they are bound by ethical obligations to get approval of the parents, making the decision-making difficult.
Beneficence
Healthcare providers are bound to act in the best interest of patients. Preterm deliveries come with uncertain prognosis making it difficult to predict consequences of resuscitation or failure to resuscitate. It becomes difficult to make some urgent but crucial decisions. Parents are also faced by dilemma because they are obliged to make the best decisions for their infants. The lack of certainty means that a parent may make decision that will lead to the infant’s death. The dilemma caused by unplanned imminent preterm delivery is faced by both parents and nurses, and it involves choosing between life and death of the infants.
Nonmaleficence
The principle of nonmaleficence requires healthcare workers to do no harm. The infants need life-sustaining care, but the nurses are limited by the viability limits. The provider must weigh the available options and chose the one which would minimize harm. A conflict of interest will occur when the parent believes in life at any cost, while resuscitation might also cause harm to the infant at the same time.
Justice
Healthcare providers must make the best treatment decisions without favor or favoritism regarding the infants’ ethnicity, race, or level of income. However, there is the concept of distributive justice. This concept considers far much more than just the care provision at the moment. It also considers health care allocation within a particular society. The decision may impact both the lifetime health of the infant and the economic situation of the parents and society.
Tentative Thesis Statement
With the advancement in neonatal care, it is possible to successfully resuscitate infants born at gestation weeks 22 to 24. However, there are medical and ethical dilemmas associated with the decision to resuscitate due to the associated morbidity and mortality.
