TY  - JOUR
T1  - ENd-of-life decisions in dutch neonatal intensive care units
AU  - Verhagen A, Dorscheidt JM, Engels B, Hubben JH, Sauer PJ
Y1  - 2009/10/05
N1  - 10.1001/archpediatrics.2009.166
JO  - Archives of Pediatrics & Adolescent Medicine
SP  - 895
EP  - 901
VL  - 163
IS  - 10
N2  - Objective 
    To clarify the practice of end-of-life decision making in severely ill newborns.Design 
    Retrospective descriptive study with face-to-face interviews.Setting 
    The 10 neonatal intensive care units in the Netherlands from October 2005 to September 2006.Patients 
    All 367 newborn infants who died in the first 2 months of life in Dutch neonatal intensive care units. Adequate documentation was available in 359 deaths.Outcome Measures 
    Presence of end-of-life decisions, classification of deaths in 3 groups, and physicians' considerations leading to end-of-life decisions.Results 
    An end-of-life decision preceded death in 95% of cases, and in 5% treatment was continued until death. Of all of the deaths, 58% were classified as having no chance of survival and 42% were stabilized newborns with poor prognoses. Withdrawal of life-sustaining therapy was the main mode of death in both groups. One case of deliberate ending of life was found. In 92% of newborns with poor prognoses, end-of-life decisions were based on patients' future quality of life and mainly concerned future suffering. Considerations regarding the infant's present state were made in 44% of infants.Conclusions 
    Virtually all deaths in Dutch neonatal intensive care units are preceded by the decision to withdraw life-sustaining treatment and many decisions are based on future quality of life. The decision to deliberately end the life of a newborn may occur less frequently than was previously assumed.
SN  - 1072-4710
M3  - doi: 10.1001/archpediatrics.2009.166
UR  - http://dx.doi.org/10.1001/archpediatrics.2009.166
ER  -