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Decisions to withdraw or withhold life-sustaining treatment are contentious, and offer difficult moral dilemmas to both medical practitioners and the judiciary. This issue is exacerbated when the patient is unable to exercise autonomy and is entirely dependent on the will of others. This book focuses on the legal and ethical complexities surrounding end of life decisions for critically impaired and extremely premature infants. Neera Bhatia explores decisions to withdraw or withhold life-sustaining treatment from critically impaired infants and addresses the controversial question, which lives are too expensive to treat? Bringing to bear such key issues as clinical guidance, public awareness, and resource allocation, the book provides a rational approach to end of life decision making, where decisions to withdraw or withhold treatment may trump other competing interests. The book will be of great interest and use to scholars and students of bioethics, medical law, and medical practitioners.
Decisions to withdraw or withhold life-sustaining treatment are contentious, and offer difficult moral dilemmas to both medical practitioners and the judiciary. This issue is exacerbated when the patient is unable to exercise autonomy and is entirely dependent on the will of others. This book focuses on the legal and ethical complexities surrounding end of life decisions for critically impaired and extremely premature infants. Neera Bhatia explores decisions to withdraw or withhold life-sustaining treatment from critically impaired infants and addresses the controversial question, which lives are too expensive to treat? Bringing to bear such key issues as clinical guidance, public awareness, and resource allocation, the book provides a rational approach to end of life decision making, where decisions to withdraw or withhold treatment may trump other competing interests. The book will be of great interest and use to scholars and students of bioethics, medical law, and medical practitioners.
Pediatric palliative care is a field of significant growth as health care systems recognize the benefits of palliative care in areas such as neonatal intensive care, pediatric ICU, and chronic pediatric illnesses. Pediatric Palliative Care, the fourth volume in the HPNA Palliative Nursing Manuals series, highlights key issues related to the field. Chapters address pediatric hospice, symptom management, pediatric pain, the neonatal intensive care unit, transitioning goals of care between the emergency department and intensive care unit, and grief and bereavement in pediatric palliative care. The content of the concise, clinically focused volumes in the HPNA Palliative Nursing Manuals series is one resource for nurses preparing for specialty certification exams and provides a quick-reference in daily practice. Plentiful tables and patient teaching points make these volumes useful resources for nurses.
The increasing prevalence of preterm birth in the United States is a complex public health problem that requires multifaceted solutions. Preterm birth is a cluster of problems with a set of overlapping factors of influence. Its causes may include individual-level behavioral and psychosocial factors, sociodemographic and neighborhood characteristics, environmental exposure, medical conditions, infertility treatments, and biological factors. Many of these factors co-occur, particularly in those who are socioeconomically disadvantaged or who are members of racial and ethnic minority groups. While advances in perinatal and neonatal care have improved survival for preterm infants, those infants who do survive have a greater risk than infants born at term for developmental disabilities, health problems, and poor growth. The birth of a preterm infant can also bring considerable emotional and economic costs to families and have implications for public-sector services, such as health insurance, educational, and other social support systems. Preterm Birth assesses the problem with respect to both its causes and outcomes. This book addresses the need for research involving clinical, basic, behavioral, and social science disciplines. By defining and addressing the health and economic consequences of premature birth, this book will be of particular interest to health care professionals, public health officials, policy makers, professional associations and clinical, basic, behavioral, and social science researchers.
A series of recent high-profile court cases has demonstrated the inadequacy of current laws in addressing issues relating to medical treatment decisions involving seriously ill children. The challenges of determining that life-sustaining medical treatment is not in a young child’s best interests have resulted in criticism of the best interests principle. This book explores the theoretical foundations of the best interests principle, and alternatives offered in the academic literature, to allow readers to understand why the principle remains contentious despite its prevalence. It provides theoretical background, exploration of what occurs in practice, and proposes a novel approach to address these challenges. Frameworks for decision-making identified in the academic literature are used to examine the application of the best interests principle in practice in England and Wales, Australia, and New Zealand through a review of the case law and qualitative research with paediatric doctors. The exploration of current practice allows readers to understand the challenges of applying the best interests principle, but also the need to retain a focus on the child. Readers are introduced to a human-rights based approach, which ensures that the focus remains on upholding the child’s best interests but also provides a more comprehensive explanation of the situation. Progressing the debate around end-of-life decision-making and children, the book will be a valuable resource for academics, researchers and policy-makers. It will also provide practical guidance to both legal and medical practitioners in managing disputes about the provision of life-sustaining treatment.
- Increased focus on international data, evidence-based research and exemplars for the principles of best practice - New chapters - Care of the normal newborn - Care of the neonate with congenital abnormality Extensively revised content on neonatal nutrition and fluid management
This book addresses the issues and challenges raised by the high-profile cases of Charlie Gard and Alfie Evans. The individual chapters, which complement one other, were written by scholars with expertise in Law, Medicine, Medical Ethics, Theology, Health Policy and Management, English Literature, Nursing and History, from the UK, Australia, Canada, the Czech Republic, France, Germany, India, Spain, Turkey and the USA. The following are among the key questions explored in the book. Is the courtroom an appropriate forum for resolving conflicts relating to medical futility in paediatrics? If so, should parental rights be protected by confining judicial powers only to cases where there is a risk of significant harm to the infant; or should the "best interests" test continue to be recognised as the "gold standard" for paediatric cases? If not, should mediation be used instead, but how well would this alternative method of dispute resolution work for medical futility conflicts? Further, should social media be deployed to garner support, and should outsiders who are not fully acquainted with the medical facts refrain from intervening? And, how are comparable situations likely to be managed in different countries? What lessons can be learned from them as well as from religious perspectives?
The death of a child is a special sorrow. No matter the circumstances, a child's death is a life-altering experience. Except for the child who dies suddenly and without forewarning, physicians, nurses, and other medical personnel usually play a central role in the lives of children who die and their families. At best, these professionals will exemplify "medicine with a heart." At worst, families' encounters with the health care system will leave them with enduring painful memories, anger, and regrets. When Children Die examines what we know about the needs of these children and their families, the extent to which such needs areâ€"and are notâ€"being met, and what can be done to provide more competent, compassionate, and consistent care. The book offers recommendations for involving child patients in treatment decisions, communicating with parents, strengthening the organization and delivery of services, developing support programs for bereaved families, improving public and private insurance, training health professionals, and more. It argues that taking these steps will improve the care of children who survive as well as those who do notâ€"and will likewise help all families who suffer with their seriously ill or injured child. Featuring illustrative case histories, the book discusses patterns of childhood death and explores the basic elements of physical, emotional, spiritual, and practical care for children and families experiencing a child's life-threatening illness or injury.
Thoroughly revised and updated, this new edition of Neonatal Intensive Care Nursing is a comprehensive, evidence-based text for nurses and allied health professionals caring for sick newborn infants. This user-friendly text focuses on the common problems and related care occurring within the neonatal specialty. All previous chapters have been thoroughly updated and new content includes chapters on, for example, organisation of neonatal care, assessment of the neonate, the premature and low birth weight neonate as well as palliative care. In addition, the book now includes a broad and in-depth web-based companion comprising online resources, case studies with answer guides and learning activities. This accessible and interactive approach enables nurses to recognise, rationalise and understand clinical problems using an evidence-based approach. Divided into four parts, the book provides an overview of neonatal care, and a detailed look at the physical and emotional wellbeing of neonate and family, a range of clinical aspects of neonatal care, and key practices and procedures. Neonatal Intensive Care Nursing will be essential reading for both new and experienced nurses, allied health professionals and students learning about neonatal care including those undertaking qualifications in the neonatal specialism and pre-registration students taking relevant modules or placements.
Medical Law and Ethics covers the core legal principles, key cases, and statutes that govern medical law alongside the key ethical debates and dilemmas that exist in the field. Carefully constructed features highlight these debates, drawing out the European angles, religious beliefs, and feminist perspectives which influence legal regulations. Other features such as 'a shock to the system', 'public opinion' and 'reality check' introduce further socio-legal discussion and contribute to the lively and engaging manner in which the subject is approached. Online resources This book is accompanied by the following online resources: - Complete bibliography and list of further reading - Links to the key cases mentioned in the book - A video from the author which introduces the book and sets the scene for your studies - Links to key sites with information on medical law and ethics - Answer guidance to one question per chapter