ObjectiveA shared decision-making (SDM) approach is recommended for prenatal decisions at the limit of viability, with a guiding role for parental values. People born extremely premature experience... Show moreObjectiveA shared decision-making (SDM) approach is recommended for prenatal decisions at the limit of viability, with a guiding role for parental values. People born extremely premature experience the consequences of the decision made, but information about their perspectives on prenatal decisions is lacking. Therefore, this study aims to describe their perspectives on what is important in decision-making at the limit of viability.DesignSemi-structured focus group discussions were conducted, recorded and transcribed verbatim. The data were independently analysed by two researchers in Atlas.ti.ResultsFour focus groups were conducted in the Netherlands, with five to six participants each, born between 240/7 and 300/7 weeks gestation in the period between 1965 and 2002. Considering their personal life experiences and how their extremely premature birth affected their families, the participants reflected on decision-making at the limit of viability. Various considerations were discussed and summarised into the following themes: anticipated parental regret, the wish to look at the baby directly after birth, to give the infant a chance at survival, quality of life, long-term outcomes for the infant and the family, and religious or spiritual considerations.ConclusionsInsights into the perspectives of adults born extremely premature deepened our understanding of values considered in decision-making at the limit of viability. Results point out the need for a more individualised prediction of the prognosis and more extensive information on the lifelong impact of an extremely premature birth on both the infant and the family. This could help future parents and healthcare professionals in value-laden decision-making. Show less
This thesis is about ethics and neonatal resuscitation. More specifically, this thesis discussed ethical challenges that are raised after the decision to provide active care, when neonatal care... Show moreThis thesis is about ethics and neonatal resuscitation. More specifically, this thesis discussed ethical challenges that are raised after the decision to provide active care, when neonatal care providers strive to provide the best possible care. The provision of the best possible care during neonatal resuscitation can be assured throughconducting research and quality improvement activities. However, conducting these activities can be ethically challenging. By combining empirical research with ethicalreasoning, this thesis aimed to provide guidance for the ethical conduct of activities to study and improve neonatal resuscitation. Show less
