Critical care decisions in fetal and neonatal medicine: ethical issues
Decision making: the ethical issues
Introduction
2.1 The purpose of this chapter is to outline a framework within which we can consider the principal ethical issues that are raised by critical care decisions for the fetus and the newborn baby. In Chapters 4–7 this framework is applied to examples of dilemmas in current practice. We begin by considering in what sense ethical analysis can help to clarify practical problems. We then examine four issues where an analysis of ethical concepts and arguments is critically important. These are the value of human life; the role of best interests; the deliberate ending of life and the withholding and withdrawing of treatment; and the weight that should be accorded to economic and social considerations.1It is important to stress that ethical issues raised by critical care decisions cannot be resolved by reference to just one of these issues. All are likely to play some role in the deliberations of the different parties involved in decisionmaking processes. We aim to identify and appraise a range of concepts and arguments that readers of this Report could use as they consider the issues that we address, or actively participate in the difficult processes of decision making that are a central focus of this Report.
1 Our use of the term ‘treatment’ in this Report does not include artificial nutrition and intravenous hydration; see Glossary for full definition.