Ethical case deliberations in the Neonatology Department

A male newborn with generalized hypotonia and imminent respiratory insufficiency was diagnosed with a metabolic disorder with a bad prognosis. To assure patient anonymity the exact diagnosis is not mentioned. The clinicians and the parents had different opinions about whether the treatment started should be continued. When paediatricians and parents differ in opinion, medical and moral facts will play an important role in deciding what is in the best interest of the child. These ethical dilemmas cause moral stress. Paediatricians and parents both have an obligation to weigh and balance all facts, values and uncertainties. Ethical case deliberations can be a valuable addition towards medical decision-making. Working on the ward, an ethicist can guide ethical deliberations and help treatment teams in making moral judgments. A structured case deliberation with ethical sound arguments based on widely held norms and values can enable consensus to be reached about the best approach. The ethicist must safeguard this process and help the treatment team to deal with moral stress. Especially in paediatrics, ethical dilemmas and moral questions will occur frequently.