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Shall parent / patient wishes be fulfilled in any case? A series of 32 ethics consultations: from reproductive medicine to neonatology
JournalArticle (Originalarbeit in einer wissenschaftlichen Zeitschrift)
 
ID 4526920
Author(s) Muggli, Mirella; De Geyter, Christian; Reiter-Theil, Stella
Author(s) at UniBasel Reiter-Theil, Stella
Muggli, Mirella
de Geyter, Christian M.H.R.
Year 2019
Title Shall parent / patient wishes be fulfilled in any case? A series of 32 ethics consultations: from reproductive medicine to neonatology
Journal BMC Medical Ethics
Volume 20
Pages / Article-Number 4
Keywords Ethics consultation; Neonatology; Obstetrics; Parent/ patients’ wishes; Patient autonomy; Reproductive medicine
Mesh terms Adult; Decision Making, ethics; Ethics Consultation; Ethics, Medical; Female; Humans; Infant, Newborn; Informed Consent, ethics, psychology; Male; Neonatology, ethics; Parents, education, psychology; Patient Advocacy, ethics, psychology; Personal Autonomy; Pregnancy; Qualitative Research; Reproductive Medicine, ethics; Retrospective Studies; Risk Assessment
Abstract Questions concerning the parent/ patient's autonomy are seen as one of the most important reasons for requesting Ethics Consultations (ECs). Respecting parent/ patient's autonomy also means respecting the patient's wishes. But those wishes may be controversial and sometimes even go beyond legal requirements. The objective of this case series of 32 ECs was to illustrate ethically challenging parent / patients' wishes during the first stages of life and how the principle of patient's autonomy was handled.; The case series has a qualitative retrospective approach. A documentary sheet was designed de novo and information was gained from EC minutes and medical charts. The cases originate from the following specialties: reproductive medicine, obstetrics and neonatology as well as two interdisciplinary cases.; Through the structured EC minutes aspects of patient / parents' wishes could be identified explicitly. Overall the patient / parents' wishes were not supported in 61% of the cases. Central reasons for rejection of patient / parent wishes were mainly the protection of the best interest of the unborn / new-born child as well as the rejection of clinical approaches that were regarded as being substandard treatment.; The study shows that treatment decisions in reproductive medicine, obstetrics and neonatology raise substantial ethical questions leading to the request for ethics consultation. The systematic case series presented here gives insight into the ethical reflection carried out to support the clinicians in their decision-making and counselling. It shows that clinicians, after using ethics consultation, make deliberate decisions that do not "automatically" fulfil the treatment requests of the patients and parents (to-be).
Publisher BioMed Central
ISSN/ISBN 1472-6939
URL https://10.1186/s12910-018-0342-x
edoc-URL https://edoc.unibas.ch/74809/
Full Text on edoc No
Digital Object Identifier DOI 10.1186/s12910-018-0342-x
PubMed ID http://www.ncbi.nlm.nih.gov/pubmed/30621671
ISI-Number WOS:000455211000003
Document type (ISI) Article
 
   

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