[Bioethics in end-of-life decisions in neonatology: Unresolved issues]

Abstract

This document is the result of previous work carried out by different expert groups and submitted to multidisciplinary debate at a Conference about controversial, deficient, or new aspects in the field of neonatal palliative care, such as: 1) the deliberative decision-making process, 2) hospital and domiciliary palliative care, 3) donation after controlled cardiac death, and 4) moral stress in professionals. The most relevant conclusions were: the need to instruct professionals in bioethics and in the deliberative method to facilitate thorough and reasonable decision-making; the lack of development in the field of perinatal palliative care and domiciliary palliative care in hospitals that attend newborns; the need to provide neonatal units with resources that help train professionals in communication skills and in the management of moral distress, as well as delineate operational procedure and guidelines for neonatal organ donation.

Keywords: Cuidado paliativo; Cuidados al final de la vida; Decision making; Decisiones éticas; Deliberación; Donación; Donation; End of life care; Estrés emocional; Ethical decisions; Moral distress; Neonate; Neonato; Palliative care.