Ethical and end of life considerations for neonates requiring ECMO support

Ethical and end of life considerations for neonates requiring ECMO support ECMO has proven to be a life-saving intervention for a variety of disease entities with a high rate of survival in the neonatal population. However, ECMO requires clinical teams to engage in many ethical considerations. Even with ongoing improvements in technology and expertise, some patients will not survive a course of ECMO. An unsuccessful course of ECMO can be difficult to accept and cause a great deal of angst. These questions can result in real conflict both within the care team, and between the care team and the family. Herein we explore a range of ethical considerations that may be encountered when caring for a patient on ECMO, with a particular focus on those courses where it appears likely that the patient will not survive. We then consider how a palliative care approach may provide a tool set to help engage the team and family in confronting the difficult decision to discontinue ECMO. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Seminars In Perinatology Elsevier

Ethical and end of life considerations for neonates requiring ECMO support

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Publisher
Elsevier
Copyright
Copyright © 2018 Elsevier Inc.
ISSN
0146-0005
eISSN
1558-075X
D.O.I.
10.1053/j.semperi.2017.12.009
Publisher site
See Article on Publisher Site

Abstract

ECMO has proven to be a life-saving intervention for a variety of disease entities with a high rate of survival in the neonatal population. However, ECMO requires clinical teams to engage in many ethical considerations. Even with ongoing improvements in technology and expertise, some patients will not survive a course of ECMO. An unsuccessful course of ECMO can be difficult to accept and cause a great deal of angst. These questions can result in real conflict both within the care team, and between the care team and the family. Herein we explore a range of ethical considerations that may be encountered when caring for a patient on ECMO, with a particular focus on those courses where it appears likely that the patient will not survive. We then consider how a palliative care approach may provide a tool set to help engage the team and family in confronting the difficult decision to discontinue ECMO.

Journal

Seminars In PerinatologyElsevier

Published: Mar 1, 2018

References

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