Nuffield Council on Bioethics / Home

NUFFIELD COUNCIL ON BIOETHICS WORKING PARTY ON CRITICAL CARE DECISIONS IN FETAL AND NEONATAL MEDICINE

Minutes of the tenth meeting held on Thursday 6th July, 2006

PRESENT: Professor Margot Brazier OBE (in the Chair), Professor David Archard, Professor Alastair Campbell, Professor Linda Franck, Professor Erica Haimes, Ms Bonnie Green, Professor Catherine Peckham CBE, Dr Stavros Petrou (morning)
Professor Charles Rodeck, Dr Philippa Russell CBE (from midday), Ms Anne Winyard, Professor Andrew Whitelaw

SECRETARIAT: Professor Sandy Thomas, Dr Catherine Moody, Caroline Rogers, Harald Schmidt

APOLOGIES: Dr Monica Konrad, Professor Neil Marlow

INTRODUCTION
1 Professor Brazier advised members that the focus of discussions would be upon the feedback from the recent meeting of the Council and the draft conclusions and recommendations. She gave a deadline for receipt of final comments on the Report.

MINUTES OF PREVIOUS MEETINGS
2 The minutes of the 9th meeting were agreed. The outcome of two subsequent informal meetings was noted and notes of remaining fact-finding meetings endorsed.

Matters Arising
CCD (06) 50
3 A proposal for revision of the Introduction was agreed to be helpful.

Draft Report:
CCD (06) 51
Feedback from the Council discussion
4 Professor Brazier drew members’ attention to the written feedback from the Council discussion of the Report which took place on 21 June 2006. The Council had congratulated the Working Party on the latest version and had appointed a small sub-group chaired by Professor Hepple, the Chair of the Council to sign off the Report at the end of August, 2006. Each Council member as well as Working Party members would receive a copy. Members of the Working Party discussed each point raised by the Council in turn. It was agreed to make it clearer that the concept of best interests was a central theme of the Report. An adjustment was needed to the description of what was meant by best interests. The Working Party would make it more explicit when members had decided not to reach a conclusion, for example in relation to the moral status of the fetus as it matured towards the point of birth. Attention was needed to ensure that the discussion of family interests compared with the baby’s interests was well cross-referenced. A Box was required to explain the concepts of intolerability and futility (2.26 and 2.27). The drafting on sanctity of life and vitalism needed some development. Stylistic adjustment was needed to ensure that the Working Party’s position on the active ending of life could not be misconstrued. The ethical discussion in Chapters 4 through 7 required further development; it should also complement Chapter 2 without undue repetition. A commentary on rights based approaches would fit well into Chapter 8. More work was needed on the presentation of statistical data. The case of Ian and his mother Jill (Ch 7) brought out very well what life was like when a child had a serious disability. Economic issues should remain integrated within the different Chapters. Although it was very difficult to obtain data, it would be useful if examples could include meaningful analogies such as comparative costs for caring for other childhood conditions. The Conclusions and Recommendations needed to be made more specific. One of the proposed recommendations was removed as being too far beyond the terms of reference of the Working Party. Two other recommendations, which were rather broad in scope, were discussed, but retained because they were important. Further stylistic adjustments to the Report were needed throughout.

Conclusions and Recommendations
The draft Conclusions and Recommendations were projected onto a screen from a lap top computer and amended as the discussion progressed. Two new recommendations were added. Cross referencing to the Children’s NSF was agreed. This section of the Report would be finalised by the Secretariat after a further circulation for members’ comments following the meeting.

Work Plan CCD
(06) 52
5 The Secretariat would continue working on the Report over the summer and it would be sent to the production manager on 13th September. The launch was on 16th November. Plans were being made for the timetable of meetings before and after the launch and these would be circulated to members. Guidance and media training would be made available to members as needed. One year following the launch of the Report, members would be invited to a reunion dinner and to assess the impact of the Report

Responses to the wider consultation
CCD (06) 53
6 Professor Brazier asked members whether there were any quotations that they would particularly like to be highlighted or written into either the Report of the Appendix that summarised the consultation responses.

Any other business
7 There was none. Professor Brazier thanked members for their valuable contributions throughout all the meetings of the Working Party and she was thanked in turn.

This was the final meeting of the Working Party

Last Updated Fri, 1 December 2006