Abstract
According to bioethical principles, babies and older patients should be treated according to the same standards. In practice, newborn infants are treated differently in ways which show that they are valued less than older individuals. We provide six specific examples of this differential treatment and analyse the possible consequences of this devaluation.
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References
American Academy of Pediatrics. Neonatal Resuscitation Program (NRP) Textbook—6th edition. 2010.
The Nuffield Council on Bioethics. ccd web version 22 June 2007. 2007 [cited; Available from: http://www.nuffieldbioethics.org/sites/default/files/CCD web version 22 June 07 (updated).pdf.
Bellieni CV, Iantorno L, Perrone S, Rodriguez A, Longini M, Capitani S, et al. Even routine painful procedures can be harmful for the newborn. Pain. 2009;147(1–3):128–31.
Peters JW, Schouw R, Anand KJ, van Dijk M, Duivenvoorden HJ, Tibboel D. Does neonatal surgery lead to increased pain sensitivity in later childhood? Pain. 2005;114(3):444–54.
Carbajal R, Rousset A, Danan C, Coquery S, Nolent P, Ducrocq S, et al. Epidemiology and treatment of painful procedures in neonates in intensive care units. JAMA. 2008;300(1):60–70.
Losacco V, Cuttini M, Greisen G, Haumont D, Pallas-Alonso CR, Pierrat V, et al. Heel blood sampling in European neonatal intensive care units: compliance with pain management guidelines. Arch Dis Child Fetal Neonatal Ed. 2011;96(1):F65–8.
Johnston C, Barrington KJ, Taddio A, Carbajal R, Filion F. Pain in Canadian NICUs: have we improved over the past 12 years? Clin J Pain. 2011;27(3):225–32.
Simons SH, van Dijk M, Anand KS, Roofthooft D, van Lingen RA, Tibboel D. Do we still hurt newborn babies? A prospective study of procedural pain and analgesia in neonates. Arch PediatrAdolesc Med. 2003;157(11):1058–64.
Yilmaz F, Arikan D. The effects of various interventions to newborns on pain and duration of crying. J ClinNurs. 2011;20(7–8):1008–17.
Cong X, Ludington-Hoe SM, Walsh S. Randomized crossover trial of kangaroo care to reduce biobehavioral pain responses in preterm infants: a pilot study. Biological research for nursing. 2011; 13(2):204–16.
Harrison D, Bueno M, Yamada J, Adams-Webber T, Stevens B. Analgesic effects of sweet-tasting solutions for infants: current state of equipoise. Pediatrics. 2010;126(5):894–902.
Brady-Fryer B, Wiebe N, Lander JA. Pain relief for neonatal circumcision. Cochrane Database Syst Rev. 2004; (4):CD004217.
Schiavenato M, Butler-O’Hara M, Scovanner P. Exploring the association between pain intensity and facial display in term newborns. Pain research &management: the journal of the Canadian Pain Society = journal de la societecanadienne pour le traitement de la douleur. 2011; 16(1):10–2.
World Medical Association. WMA Declaration of Helsinki—Ethical Principles for Medical Research Involving Human Subjects. 2008 [cited; Available from: http://www.wma.net/en/30publications/10policies/b3/index.html. 2008.
World Health Organization. WHO Guidelines for Community Noise. 2010 [cited; Available from: http://www.who.int/docstore/peh/noise/ComnoiseExec.htm. 2010.
Philbin MK, Robertson A, Hall JW 3rd. Recommended permissible noise criteria for occupied, newly constructed or renovated hospital nurseries. Adv Neonatal Care. 2008;8(5):S11–5.
Janvier A, Lantos J. Variations of practice in the care of extremely preterm infants. In: Diekema D, Mercurio M, Adam M, editors. Clinical Ethics in Pediatrics, a Case-Based Textbook: Cambridge University Press; 2011. p. 94–100.
Janvier A, Barrington KJ, Aziz K, Lantos J. Ethics ain’t easy: do we need simple rules for complicated ethical decisions? Acta Paediatr. 2008;97(4):402–6.
Dupont-Thibodeau A, Barrington KJ, Farlow B, Janvier A. End-of-life decisions for extremely low-gestational-age infants: why simple rules for complicated decisions should be avoided. SeminPerinatol. 2014;38(1):31–7.
Laventhal N, Spelke MB, Andrews B, Larkin LK, Meadow W, Janvier A. Ethics of resuscitation at different stages of life: a survey of perinatal physicians. Pediatrics. 2011;127(5):e1221–9.
Armstrong K, Ryan CA, Hawkes CP, Janvier A, Dempsey EM. Life and death decisions for incompetent patients: determining best interests–the Irish perspective. Acta Paediatr. 2011;100(4):519–23.
Janvier A, Leblanc I, Barrington KJ. Nobody likes premies: the relative value of patients’ lives. J Perinatol. 2008;28(12):821–6.
Janvier A, Leblanc I, Barrington KJ. The best-interest standard is not applied for neonatal resuscitation decisions. Pediatrics. 2008;121(5):963–9.
Hansen TW, Janvier A, Aasland O, Forde R. Ethics, choices, and decisions in acute medicine: a national survey of Norwegian physicians’ attitudes. PediatrCrit Care Med. 2013;14(2):e63–9.
Hagen EM, Therkelsen OB, Førde R, Aasland O, Janvier A, Hansen TW. Challenges in reconciling best interest and parental exercise of autonomy in pediatric life-or-death situations. J Pediatr. 2012;161(1):146–51.
Jefferies AL, Kirpalani HM. Counselling and management for anticipated extremely preterm birth. Paediatrics Child Health. 2012; 17(8):443–6.
Kaempf JW, Tomlinson M, Arduza C, Anderson S, Campbell B, Ferguson LA, et al. Medical staff guidelines for periviability pregnancy counseling and medical treatment of extremely premature infants. Pediatrics. 2006;117(1):22–9.
Weisfeldt ML, Everson-Stewart S, Sitlani C, Rea T, Aufderheide TP, Atkins DL, et al. Ventricular tachyarrhythmias after cardiac arrest in public versus at home. N Engl J Med. 2011;364(4):313–21.
Fontana MS, Farrell C, Gauvin F, Lacroix J, Janvier A. Modes of death in pediatrics: differences in the ethical approach in neonatal and pediatric patients. J Pediatr. 2013;162(6):1107–11.
Rebagliato M, Cuttini M, Broggin L, Berbik I, de Vonderweid U, Hansen G, et al. Neonatal end-of-life decision making: Physicians’ attitudes and relationship with self-reported practices in 10 European countries. JAMA. 2000;284(19):2451–9.
Marcello KR, Stefano JL, Lampron K, Barrington KJ, Mackley AB, Janvier A. The influence of family characteristics on perinatal decision making. Pediatrics. 2011;127(4):e934–9.
Doyle LW. Neonatal intensive care at borderline viability—is it worth it? Early Hum Dev. 2004;80(2):103–13.
Lantos JD, Mokalla M, Meadow W. Resource allocation in neonatal and medical ICUs. Epidemiology and rationing at the extremes of life. Am JRespir Crit Care Med. 1997; 156(1):185–9.
Doyle LW, The Victorian Infant Collaborative Study Group. Evaluation of neonatal intensive care for extremely low birth weight infants in Victoria over two decades: II. Efficiency. Pediatrics. 2004;113(3 Pt 1):510–4.
Lawn JE, Cousens SN, Darmstadt GL, Bhutta ZA, Martines J, Paul V, et al. 1 year after the lancet neonatal survival series–was the call for action heard? Lancet. 2006;367(9521):1541–7.
Lozano R, Wang H, Foreman KJ, Rajaratnam JK, Naghavi M, Marcus JR, et al. Progress towards Millennium Development Goals 4 and 5 on maternal and child mortality: an updated systematic analysis. Lancet. 2011;378(9797):1139–65.
Manasyan A, Chomba E, McClure EM, Wright LL, Krzywanski S, Carlo WA. Cost-effectiveness of essential newborn care training in urban first-level facilities. Pediatrics. 2011;127(5):e1176–81.
Miljeteig I, Johansson KA, Sayeed SA, Norheim OF. End-of-life decisions as bedside rationing. An ethical analysis of life support restrictions in an Indian neonatal unit. J Med Ethics. 2010;36(8):473–8.
Miljeteig I, Sayeed SA, Jesani A, Johansson KA, Norheim OF. Impact of ethics and economics on end-of-life decisions in an Indian neonatal unit. Pediatrics. 2009;124(2):e322–8.
Jamison DT, Shahid-Salles SA, Jamison J, Lawn JE, Zupan J. Incorporating Deaths Near the Time of Birth into Estimates of the Global Burden of Disease. In: Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJL, editors. Global Burden of Disease and Risk Factors.Washington (DC); 2006.
Committee on Issues PfNVD, Division of Health Promotion, Disease Prevention IoM. New Vaccine Development: Establishing Priorities: Diseases of Importance in the United States: The National Academies Press; 1985.
Johannesson M, Johansson PO. Is the valuation of a QALY gained independent of age? Some empirical evidence. J Health Econ. 1997;16(5):589–99.
Cropper ML, Aydede SK, Portney PR. Preferences for life saving programs: how the public discounts time and age. Journal of Risk and Uncertainty. 1994;8(3):243–65.
McMahan J. The ethics of killing: problems at the margins of life. Oxford: Oxford University Press; 2002.
Singer P. Practical ethics. Cambridge: Cambridge University Press; 2011.
Waring DWR. Medical benefit and the human lottery: an egalitarian approach to patient selection. Berlin: Springer; 2004.
Janvier A, Bauer KL, Lantos JD. Are newborns morally different from older children? TheorMedBioeth. 2007;28(5):413–25.
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Janvier, A., Bellieni, C., Barrington, K. (2016). Neonates Are Devalued Compared to Older Patients. In: Verhagen, E., Janvier, A. (eds) Ethical Dilemmas for Critically Ill Babies. International Library of Ethics, Law, and the New Medicine, vol 65. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-7360-7_4
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DOI: https://doi.org/10.1007/978-94-017-7360-7_4
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