Decisions for Treatment of Neonates With Poor Prognosis: A Qualitative Study
Advances in medicine and medical technology have presented new moral challenges in terms of the management of extremely preterm infants and newborns with severe anomalies and advanced asphyxia. The aim of the present study was to examine the attitudes of health care providers and parents regarding...
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| Format: | Article |
| Language: | English |
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Tehran University of Medical Sciences
2022-07-01
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| Series: | Acta Medica Iranica |
| Subjects: | |
| Online Access: | https://acta.tums.ac.ir/index.php/acta/article/view/9415 |
| _version_ | 1818189230752399360 |
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| author | Mamak Shariat Fariba Asghari Mahmoud Motevasel Arani Nahid Farrokhzad Yasamin Mohammadzadeh Farahnaz Mohammadi Shahboulaghi Ameneh Abroun Sayeh Mirzatavoli Zohreh Janani Fatemeh Sadat Nayeri |
| author_facet | Mamak Shariat Fariba Asghari Mahmoud Motevasel Arani Nahid Farrokhzad Yasamin Mohammadzadeh Farahnaz Mohammadi Shahboulaghi Ameneh Abroun Sayeh Mirzatavoli Zohreh Janani Fatemeh Sadat Nayeri |
| author_sort | Mamak Shariat |
| collection | DOAJ |
| description |
Advances in medicine and medical technology have presented new moral challenges in terms of the management of extremely preterm infants and newborns with severe anomalies and advanced asphyxia. The aim of the present study was to examine the attitudes of health care providers and parents regarding decisions about the treatment of these neonates. The attitude of the Shia clerics is assessed in this study as well. In this qualitative content analysis research, data were collected through semi-structured interviews and focus group discussions (FGDs) with 98 participants, including physicians, nurse practitioners, medical ethicists, Shia clerics, and parents. Purposive sampling was employed by selecting those members of the community whom we thought would provide us with the best information and were also eager to participate. Data collection continued until data saturation was reached. Data analysis was carried out using conventional content analysis. Analysis of the data resulted in the extraction of 332 codes along with the following four categories: the necessity for preparation of a national guideline for the management of neonates with poor prognosis, the establishment of hospital neonatal-management committees, decision-making regarding the limits of viability, and parental support. This study affirms that the responsibility in terms of decision-making for neonates with poor prognosis lies upon hospital neonatal-management committees based on approved national guidelines such that decisions are made according to the aforementioned guidelines, Islamic moral codes, and scope of services available in medical units. This study dismisses individual decision-making and underlines the responsibility of a hospital neonatal-management committee in making decisions based on approved guidelines that conform to the regulations of national law and Islamic moral codes that determine the continuation or withdrawal of medical care and treatment of infants with a poor prognosis while bearing in mind that regulations, hospital facilities, resources, and other conditions differ in various hospitals within the country and with developed countries.
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| first_indexed | 2024-12-11T23:39:31Z |
| format | Article |
| id | doaj.art-1e45d994ef9d4996933b1c7305db0795 |
| institution | Directory Open Access Journal |
| issn | 0044-6025 1735-9694 |
| language | English |
| last_indexed | 2024-12-11T23:39:31Z |
| publishDate | 2022-07-01 |
| publisher | Tehran University of Medical Sciences |
| record_format | Article |
| series | Acta Medica Iranica |
| spelling | doaj.art-1e45d994ef9d4996933b1c7305db07952022-12-22T00:45:47ZengTehran University of Medical SciencesActa Medica Iranica0044-60251735-96942022-07-0160610.18502/acta.v60i6.10041Decisions for Treatment of Neonates With Poor Prognosis: A Qualitative StudyMamak Shariat0Fariba Asghari1Mahmoud Motevasel Arani2Nahid Farrokhzad3Yasamin Mohammadzadeh4Farahnaz Mohammadi Shahboulaghi5Ameneh Abroun6Sayeh Mirzatavoli7Zohreh Janani8Fatemeh Sadat Nayeri9Maternal, Fetal and Neonatal Health Research Center, Institute of Family Health, Tehran University of Medical Sciences, Tehran, IranMedical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, IranDepartment of Islamic Maaref, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.Maternal, Fetal and Neonatal Health Research Center, Institute of Family Health, Tehran University of Medical Sciences, Tehran, IranBreastfeeding Research Center, Institute of Family Health, Tehran University of Medical Sciences, Tehran, IranSocial Determinants of Health Research Center, Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, IranNeonatal Intensive Care Unit, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, IranNeonatal Intensive Care Unit, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, IranNurse in Neonatal Intensive Care Unit, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, IranMaternal, Fetal and Neonatal Health Research Center, Institute of Family Health, Tehran University of Medical Sciences, Tehran, Iran Advances in medicine and medical technology have presented new moral challenges in terms of the management of extremely preterm infants and newborns with severe anomalies and advanced asphyxia. The aim of the present study was to examine the attitudes of health care providers and parents regarding decisions about the treatment of these neonates. The attitude of the Shia clerics is assessed in this study as well. In this qualitative content analysis research, data were collected through semi-structured interviews and focus group discussions (FGDs) with 98 participants, including physicians, nurse practitioners, medical ethicists, Shia clerics, and parents. Purposive sampling was employed by selecting those members of the community whom we thought would provide us with the best information and were also eager to participate. Data collection continued until data saturation was reached. Data analysis was carried out using conventional content analysis. Analysis of the data resulted in the extraction of 332 codes along with the following four categories: the necessity for preparation of a national guideline for the management of neonates with poor prognosis, the establishment of hospital neonatal-management committees, decision-making regarding the limits of viability, and parental support. This study affirms that the responsibility in terms of decision-making for neonates with poor prognosis lies upon hospital neonatal-management committees based on approved national guidelines such that decisions are made according to the aforementioned guidelines, Islamic moral codes, and scope of services available in medical units. This study dismisses individual decision-making and underlines the responsibility of a hospital neonatal-management committee in making decisions based on approved guidelines that conform to the regulations of national law and Islamic moral codes that determine the continuation or withdrawal of medical care and treatment of infants with a poor prognosis while bearing in mind that regulations, hospital facilities, resources, and other conditions differ in various hospitals within the country and with developed countries. https://acta.tums.ac.ir/index.php/acta/article/view/9415Poor prognosis newbornsDecision-makingLimits of viability |
| spellingShingle | Mamak Shariat Fariba Asghari Mahmoud Motevasel Arani Nahid Farrokhzad Yasamin Mohammadzadeh Farahnaz Mohammadi Shahboulaghi Ameneh Abroun Sayeh Mirzatavoli Zohreh Janani Fatemeh Sadat Nayeri Decisions for Treatment of Neonates With Poor Prognosis: A Qualitative Study Acta Medica Iranica Poor prognosis newborns Decision-making Limits of viability |
| title | Decisions for Treatment of Neonates With Poor Prognosis: A Qualitative Study |
| title_full | Decisions for Treatment of Neonates With Poor Prognosis: A Qualitative Study |
| title_fullStr | Decisions for Treatment of Neonates With Poor Prognosis: A Qualitative Study |
| title_full_unstemmed | Decisions for Treatment of Neonates With Poor Prognosis: A Qualitative Study |
| title_short | Decisions for Treatment of Neonates With Poor Prognosis: A Qualitative Study |
| title_sort | decisions for treatment of neonates with poor prognosis a qualitative study |
| topic | Poor prognosis newborns Decision-making Limits of viability |
| url | https://acta.tums.ac.ir/index.php/acta/article/view/9415 |
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