Ekstremt for tidligt født og etiske overvejelser.
Inspireret af YP's årsmøde med glimrende undervisning fra læge Jesper Fenger Grøn, fokuserer november måneds journal club på de overvejelser der knytter sig til de børn der fødes på grænsen til liv.
Hvad er det amerikanske syn på den "scandinaviske tilgang" hvor forældre tages med på råd hvad angår behandlingsniveau - og gør vi det overhovedet ens her i Norden?
læs bl.a. artiklen: "Do Sociocultural Factors Influence Periviability Counseling and Treatment More Than Science? Lessons From Scandinavia"
af John D Lantos et al
September udgaven af Pediatrics fokuserer på dette spændende område og ud over ovenstående kan du også læse artiklen skrevet af bl.a. den danske læge og neonatolog Gorm Greisen.
Find hele septemberudgaven her
og læs månedens artikel her
Abstract:
"All of us (doctors, parents, bioethicists, and health policy makers) think differently about premature infants who require neonatal intensive care than we do about other patients who are critically ill. In most other clinical circumstances, those that involve patients other than premature infants, our first impulse when confronted with a patient in an emergency is to do whatever we can to rescue the patient. We offer life-sustaining treatments first and ask questions later. With extremely premature infants, by contrast, we first ask questions, ponder our options, and try to develop policies about whether it is appropriate to try to save these infants. We wonder aloud whether these tiny patients are even worth saving. In most countries that have NICUs, and in many hospitals, doctors and policy makers have explicitly specified which infants ought to be offered life-sustaining treatment and which should be allowed to die. Regarding the treatment of infants who are born at the borderline of viability, there are markedly distinct approaches in Sweden, Norway, and Denmark. In each country, the prevailing approaches were developed after careful consideration of many factors, including public sentiment, professional preferences, reported outcomes, philosophical factors, and considerations of cost and cost-effectiveness. In this article, we comment on some of these considerations and the soundness of the resulting practice variations."
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