Evidence map›Paper›PMID 36670597›Full record

ArticleChildren (Basel, Switzerland)2022

"We Absolutely Had the Impression That It Was Our Decision"-A Qualitative Study with Parents of Critically Ill Infants Who Participated in End-of-Life Decision Making.

Maria Florentine Beyer, Katja Kuehlmeyer, Pezi Mang, Andreas W Flemmer, Monika Führer, Georg Marckmann, Mirjam de Vos, Esther Sabine Schouten

Abstract read
In one paragraph

Article in Children (Basel, Switzerland), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Maria Florentine BeyerDivision Neonatology, Department of Pediatrics, Dr. von Hauner Children's Hospital, LMU University Hospital, 80337 Munich, Germany.ORCID 0000-0001-5425-3562
Katja KuehlmeyerInstitute of Ethics, History and Theory of Medicine, LMU Munich, 80336 Munich, Germany.ORCID 0000-0003-2839-8850
Pezi MangDivision Neonatology, Department of Pediatrics, Dr. von Hauner Children's Hospital, LMU University Hospital, 80337 Munich, Germany.ORCID 0000-0003-2623-9143
Andreas W FlemmerDivision Neonatology, Department of Pediatrics, Dr. von Hauner Children's Hospital, LMU University Hospital, 80337 Munich, Germany.
Monika FührerCenter for Pediatric Palliative Care, Department of Pediatrics, Dr. von Hauner Children's Hospital, LMU University Hospital, 80364 Munich, Germany.
Georg MarckmannInstitute of Ethics, History and Theory of Medicine, LMU Munich, 80336 Munich, Germany.ORCID 0000-0002-6898-9500
Mirjam de VosDepartment of Paediatrics, Emma Children's Hospital, Amsterdam University Medical Centre, 1081 HV Amsterdam, The Netherlands.
Esther Sabine SchoutenDivision Neonatology, Department of Pediatrics, Dr. von Hauner Children's Hospital, LMU University Hospital, 80337 Munich, Germany.ORCID 0000-0002-9347-8155

Funding

German Ministry of Education and Research Grant no. 01GY1718
6 · The paper itself

Abstract

backgroundGuidelines recommend shared decision making (SDM) between neonatologists and parents when a decision has to be made about the continuation of life-sustaining treatment (LST). In a previous study, we found that neonatologists and parents at a German Level-III Neonatal Intensive Care Unit performed SDM to a variable but overall small extent. However, we do not know whether parents in Germany prefer an extent of more or sharing.

methodsWe performed a qualitative interview study with parents who participated in our first study. We analyzed the semi-structured interviews with qualitative content analysis according to Kuckartz.

resultsThe participation in medical decision making (MDM) varied across cases. Overall, neonatologists and parents conducted SDM in most cases only to a small extent. All parents appreciated their experience independent of how much they were involved in MDM. The parents who experienced a small extent of sharing were glad that they were protected by neonatologists from having to decide, shielding them from a conflict of interest. The parents who experienced a large extent of sharing especially valued that they were able to fulfil their parental duties even if that meant partaking in a decision to forgo LST. DISCUSSION: Other studies have also found a variety of possibilities for parents to partake in end-of-life decision making (EOL-DM). Our results suggest that parents do not have a uniform preference for one specific decision-making approach, but rather different parents appreciate their individual experience regardless of the model for DM.

conclusionSDM is apparently not a one-size-fits-all approach. Instead, neonatologists and parents have to adapt the decision-making process to the parents' individual needs and preferences for autonomy and protection. Therefore, SDM should not be prescribed as a uniform standard in medico-ethical guidelines, but rather as a flexible guidance for DM for critically ill patients in neonatology.

Indexed as

parental involvementprematurityshared decision making (MeSH)withdrawing treatmentwithholding treatment (MeSH)

Identifiers

PMID36670597
PMCPMC9856896

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