Neonatology pp 117-121 | Cite as

The Process of Decision-Making

  • Endla K. Anday
  • Maria Delivoria-Papadopoulos


In the past 40 years, tremendous progress has occurred in the care of the neonatal patient. An in-depth understanding of fetal and neonatal physiology and the molecular basis of pathological processes, concurrent with advancements in biomedical technology, have impacted favorably upon the survival of the newborn. However, extremely premature infants at the threshold of viability, infants diagnosed with potentially lethal congenital malformations, including chromosomal abnormalities, and neonates suffering from profound intrapartum and postnatal insults present difficult moral, ethical, cultural and social challenges for both families and caregivers in regard to providing or withholding life supportive measures. The decision to withhold or terminate treatment for an infant is based on defining the issues central to this process, including: the values and rights of the infant as an individual, the values of the family and the medical caregivers and the cultural influences and societal values that shape the moral arguments that affect one’s judgment. Part of the challenge resides in the complexity of defining who is or should be responsible for making difficult decisions resulting in the death of a newborn since fundamentally this type of decision is at odds with human nature even in situations where the end of life would mean no further suffering for the infant.


Premature Infant Neonatal Resuscitation Medical Care Provider Neonatal Resuscitation Program Groningen Protocol 


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Copyright information

© Springer-Verlag Italia 2012

Authors and Affiliations

  • Endla K. Anday
    • 1
  • Maria Delivoria-Papadopoulos
  1. 1.Department of Pediatrics, Drexel University College of MedicineSt. Christopher’s Hospital for ChildrenPhiladelphiaUSA

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