Abstract
Objective:
The objective of this study is to determine how neonatologists and bioethicists conceptualize and apply the Best Interests Standard (BIS).
Study Design:
Members of the American Society for Bioethics and Humanities and the American Academy of Pediatrics Section on Neonatal-Perinatal Medicine were surveyed to determine how they conceptualized the BIS and ranked the appropriateness of forgoing life-sustaining therapy (LST).
Results:
Neonatologists’ median response supported an infant-specific BIS conceptualization that linked the infant’s and family’s interests. They did not support allowing limitations on the family’s obligations. Ethicists’ supported a conceptualization that linked the infant’s and family’s interests and limitations on the family’s obligations, a less infant-specific conceptualization. Ethicists were less or equally likely to agree with forgoing LST in seven of eight cases.
Conclusions:
Ethicists endorsed a conceptualization of the BIS that includes the effects on the family and rejected an infant-specific one. Neonatologists split between these two and rejected limiting the family’s obligations. Critical appraisal of the BIS is needed in neonatal ethics.
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Acknowledgements
This research was supported by an NIH K23 grant and the Texas Children’s Hospital Bad Pants Fund.
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Supplementary Information accompanies the paper on the Journal of Perinatology website
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Placencia, F., Ahmadi, Y. & McCullough, L. Three decades after Baby Doe: how neonatologists and bioethicists conceptualize the Best Interests Standard. J Perinatol 36, 906–911 (2016). https://doi.org/10.1038/jp.2016.87
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DOI: https://doi.org/10.1038/jp.2016.87
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