Lege Artis Medicinae

[Attitudes towards end-of-life decisions among neonatology intensive care workers – Legal aspects behind decisions ]

FEITH Helga Judit1, SALLAI Eszter Zsófia2, SOÓSNÉ Kiss Zsuzsanna3, GÉZSI András4,5, GRADVOHL Edina1, KOVÁCS Aranka6, BERBIK István7, SZABÓ Miklós8

JULY 18, 2022

Lege Artis Medicinae - 2022;32(06-07)

DOI: https://doi.org/10.33616/lam.32.023

Journal Article

[Minors’ end-of-life dilemmas are among the most difficult decisions. Premature infants’ chance of survival has greatly improved thanks to the development of technology. Under-age children’s quality of life, as an aspect, does not appear in the effective Hungarian legislation. The aim of our study is to survey the change in NICU (neonatology intensive care unit) workers’ opinions/attitudes after a 20-year-period about restrictions in severely impaired new-borns’ intensive cares. Quantitative, complete sociological surveys in the Hungarian NICUs using self-administered, anonymous questionnaires (n = 728). Cross-Tabulation analysis and Pearson chi-squared test have been used for the data evaluation. In both studies, the majority of participants agreed that if the condition is fatal, it may be appropriate to limit the intensive care. Acceptance of treatment withdrawal has increased, but active euthanasia is still not accepted. Most healthcare workers are unsatisfied with the current legal order and there is a need for change, especially in cases of fatal and poor prognosis. Despite the fact that the effective Hungarian health care regulation does not allow withdrawal of treatment even in severe conditions, a significant number of those working at Hungarian NICUs would consider it as acceptable in some cases, moreover the share of acceptance has in­creased in the last two decades. Comparing the results with the current regulations, it can be suggested that it is necessary to increase the sensitivity of the legislators and to change the related legislation.]

AFFILIATIONS

  1. Semmelweis Egyetem, Egészségtudományi Kar, Társadalomtudományi Tanszék
  2. Szent János Kórház és Észak-budai Egyesített Kórházak Perinatális Intenzív Centrum
  3. Széchenyi István Egyetem, Egészség- és Sporttudományi Kar, Egészségtudományi Tanszék
  4. MTA-SE Immun-Proteogenomikai Extracelluláris Vezikula Kutatócsoport
  5. Budapesti Műszaki és Gazdaságtudományi Egyetem, Villamosmérnöki és Informatikai Kar, Méréstechnika és Információs Rendszerek Tanszék
  6. Semmelweis Egyetem, Egészségtudományi Kar, Egészségtudományi Klinikai Tanszék
  7. Vaszary Kolos Kórház, Szülészeti-Nőgyógyászati Osztály
  8. Semmelweis Egyetem, Neonatológiai Tanszéki csoport I. Sz. Gyermekklinika

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[In a three-part article series, we present (1) the clinical protocol used by the Early Childhood Eating and Sleep Disorders Outpatient Clinic of the Heim Pál National Pediatric Institute; (2) the follow-up monitoring methodology of treatment efficacy; and (3) the first results obtained by this moni­toring program in a three-part ar­ticle. The Clinic with in-patient background was the first in the Hungarian health care system to provide organized care by interdisciplinary methods for families of infants and young children struggling with early child­hood emotional and behavioural regulation problems. The present first article concerns the clinical protocol of our facility based on the international literature and our own prior experiences. In the literature review, we emphasize especially the early childhood range of care for eating and sleep disorders. Thus, we justify the rationale of structure and activities of our Outpatient Clinic launched in 2017 by a brief summary of the international literature. Our aim is to inspire further health care providers to set up similar interdisciplinary services by a detailed description of our facility. ]

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