DECISION-MAKING IN THE CRITICALLY ILL NEONATE - CULTURAL BACKGROUND VINDIVIDUAL LIFE EXPERIENCES

Objectives-In treating critically ill neonates, situations occasionall y arise in which aggressive medical treatment prolongs the inevitable death rather than prolonging life. Decisions as to limitation of neona tal medical intervention remain controversial aid the primary responsi bility of the generally unprepared family. This research was designed to study response patterns of expectant mothers towards treatment of c ritically ill and/or malformed infants. Design/setting-Attitudes were studied via comprehensive questionnaires divided into three sections. 1-Sociodemographic data and prior personal experience with perinatal p roblems; 2-Theoretical philosophical principles used in making medical ethical decisions; and 3-Hypothetical case scenarios with choices of treatment options. Subjects and results-Six hundred and fifty pregnant women were studied. Maternal birthplace (p=0.005) and level of religi ous observance (p=0.02) were strongly associated with the desire for m aximally aggressive medical intervention in the hypothetical case scen ario. Specific personal experiences such as infertility problems, prev ious children with serious mental or physical problems were not correl ated with the selection of different treatment choices. Of the theoret ical principles studied, only the desire to preserve life at all costs was significantly associated with the choice for maximal medical trea tment (p=0.03). Conclusions-Maternal ethnocultural background and phil osophical principles more profoundly influenced medical ethical decisi on-making than did specific personal life experiences.