tailieunhanh - Extreme Prematurity - Practices, Bioethics, And The Law Part 3

Tỷ lệ tử vong cao ở trẻ sơ sinh được cộng đồng y tế Anh nhận ra ngay từ những năm 1860. Chăm sóc tích cực sơ sinh hiện đại gần đây tương đối tiến bộ. Năm 1898, Bác sỹ Joseph B. De Lee thiết lập một [lồng ấp] cho trẻ sơ sinh đẻ non đầu tiên tại Chicago, Illinois, Hoa Kỳ. | PERCEPTIONS AND PRACTICES not wanting to make a life or death decision themselves but are willing to accept transferring the responsibility onto a person in authority. It is apparent that there are conflicting views between parents and physicians as well as varying opinions within and between countries. 44 149-153 De Leeuwet al. 154 compared the treatment choices of physicians and nurses in 11 European countries for a hypothetical case of an EPTI born weighing 560g at 24 weeks gestation and an Apgar score of 1 at 1 minute. The responses collected in 1996 through 1997 came from 143 NICUs in Italy Spain France Germany the Netherlands Luxembourg Britain Sweden Hungary Estonia and Lithuania. In summary most physicians in every country except the Netherlands would resuscitate the baby. However should the baby s condition deteriorate following seizures and a severe although unilateral intraventricular hemorrhage with parenchymal involvement most physicians in France the Netherlands and Luxembourg and most but fewer in Sweden Britain Spain and Lithuania would favor limiting or withdrawing intensive care. Physicians in Estonia Hungary Germany and Italy were less likely to support this approach. Of interest was that most in Estonia France and Italy and a significant number in Hungary Sweden Spain and Lithuania would carry out their decision whatever it was without involving the parents. In Estonia Hungary Italy Germany and Spain most physicians would only withhold treatment in circumstances such as a cardiac arrest if the parents requested a withdrawing of intensive care in the circumstance described. However in Britain the Netherlands and Sweden they would withdraw mechanical ventilation and a substantial number of physicians in France and the Netherlands would administer drugs with the purpose of ending the baby s life. There were other factors apart from parental wishes that influenced the decisions of physicians. For example 41 THE EXTREMELY PRETERM INFANT those who .

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