Despite the rapid technical innovations in neonatology, a considerable proportion of newborns still die shortly after birth. The death of many of these infants is often preceded by an end-of-life decision. End-of-life decisions are medical decisions with the effect or the probable effect that death is caused or hastened. They include the decision to withhold or withdraw life-sustaining treatment, as well as the decision to deliberately end a newborn’s life with lethal drugs.
Neonatal end-of-life decision-making is one of the most controversial areas of medicine as it raises all kinds of medical, ethical and legal questions regarding clinical management of severely ill newborns. End-of-life decisions in Dutch neonatal intensive care units examines these questions and provides a description of end-of-life decision-making practice in the Netherlands based on empirical studies by the author and his colleagues.
The first part of the book covers physician’s end-of-life decision-making considerations, including those leading to deliberate termination of life, the role of the parents and the use of medication as a part of end-of-life decisions. The last section covers a comparison of end-of-life decision-making in four NICU’s in the USA, Canada and the Netherlands followed by a reflection on the key aspects of Dutch neonatal end-of-life decision-making.
Eduard Verhagen works as a pediatrician at the
Beatrix Children’s Hospital,University Medical Center
Groningen in the Netherlands.
1. General introduction and outline of the thesis
2. The Groningen protocol Euthanasia in severely ill newborns
3. Physician medical decision-making at the end of life in newborns: insight into implementation at 2 Dutch centers
4. End-of-life decisions in severely ill newborns in the Dutch NICU
5. Differences of opinion regarding end-of-life decisions in severely ill newborns in the NICU; results of a nationwide study in the Netherlands
6. Analgesics, sedatives and neuromuscular blockers as part of of-life decisions in Dutch NICU’s
7. Categorizing neonatal deaths; a cross-cultural study in the USA, Canada and the Netherlands
8. Summary and general discussion
Summary in Dutch (Samenvatting in het Nederlands)
Biography and Publications