Evidence map›Paper›PMID 38969916›Full record

ArticleJournal of bioethical inquiry2024

Doctor-Parent Disagreement for Preterm Infants Born in the Grey Zone: Do Ethical Frameworks Help?

Alice Cavolo, Danya F Vears, Gunnar Naulaers, Bernadette Dierckx de Casterlé, Lynn Gillam, Chris Gastmans

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Article in Journal of bioethical inquiry, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Alice CavoloCentre for Biomedical Ethics and Law, KU Leuven, Kapucijnenvoer 9, 3000, Leuven, Belgium. alice.cavolo@kuleuven.be.ORCID 0000-0002-3921-0617
Danya F VearsMurdoch Children's Research Institute, Parkville, Victoria, Australia.
Gunnar NaulaersPregnancy, Fetus and Newborn, Department of Development and Regeneration, KU Leuven, Leuven, Belgium.
Bernadette Dierckx de CasterléAcademic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium.
Lynn GillamRoyal Children's Hospital Melbourne, Parkville, Victoria, Australia.
Chris GastmansCentre for Biomedical Ethics and Law, KU Leuven, Leuven, Belgium.

Funding

Fonds Wetenschappelijk Onderzoek 1144319N
6 · The paper itself

Abstract

objectiveTo examine i) how ethical frameworks can be used in concrete cases of parent-doctors' disagreements for extremely preterm infants born in the grey zone to guide such difficult decision-making; and ii) what challenges stakeholders may encounter in using these frameworks.

designWe did a case analysis of a concrete case of parent-doctor disagreement in the grey zone using two ethical frameworks: the best interest standard and the zone of parental discretion.

resultsBoth ethical frameworks entailed similar advantages and challenges. They have the potential 1) to facilitate decision-making because they follow a structured method; 2) to clarify the situation because all relevant ethical issues are explored; and 3) to facilitate reaching an agreement because all parties can explain their views. We identified three main challenges. First, how to objectively evaluate the risk of severe disability. Second, parents' interests should be considered but it is not clear to what extent. Third, this is a value-laden situation and different people have different values, meaning that the frameworks are at least partially subjective.

conclusionsThese challenges do not mean that the ethical frameworks are faulty; rather, they reflect the complexity and the sensitivity of cases in the grey zone.

Indexed as

Decision MakingDissent and DisputesInfant, Extremely PrematureParentsPhysiciansProfessional-Family RelationsFemaleHumansInfant, NewbornInfant, PrematureBest interestEthics; NeonatologyExtremely preterm infantsZone of parental discretion

Identifiers

PMID38969916

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.