Changing the focus of care: from curative to palliative care

Abstract

The improvements in the obstetrical and neonatal diagnosis and therapies have resulted into an increase in the survival rate of infants previously considered as non-viable. Debate is focusing on professionals’ behaviour about withdrawal or withholding of life sustaining treatment (LST) and administration of palliative care for newborns whose conditions are incompatible with a prolonged life.

Decisions about treatment should be made jointly by the professionals’ team and the family, placing the interest of the baby at the very heart of the decision process. It is very important that the environment in which the family has to make the decision is characterized by openness, dialogue and frankness.

A proper and effective communication with parents is always necessary and can resolve any conflict caused by disagreement. Furthermore, parents need time in the decision making process.

Other supports, which could help the family in the final decision are the possibility to ask for a specialist’s second opinion and the involvement of religious leaders and of an indipendent clinical ethics committee.

Withholding or withdrawal of LST does not mean cessation of care for the baby, it means to change the focus of care from curative to palliative care.

Proceedings of the 10^th International Workshop on Neonatology · Cagliari (Italy) · October 22^nd-25^th, 2014 · The last ten years, the next ten years in Neonatology

Guest Editors: Vassilios Fanos, Michele Mussap, Gavino Faa, Apostolos Papageorgiou