The offer they can't refuse: parents and perinatal treatment decisions

Semin Fetal Neonatal Med. 2008 Oct;13(5):329-34. doi: 10.1016/j.siny.2008.03.004. Epub 2008 May 16.


Despite a widespread myth of parental autonomy in decision-making for extremely preterm neonates, families in the United States are often not given access to accurate information about the consequences of preterm birth, resuscitation and treatment, or about their ethical options. Professional, philosophical, and financial incentives for hospitals and neonatologists to provide intensive treatment may trump parental wishes in delivery rooms and neonatal units. Parents may also be intimidated by the atmosphere of intensive care and by the behavior of committed staff. Prenatal advance directives allow parents to receive information on outcomes, treatments, and options, including palliative care, 'on their own turf' and as a part of routine prenatal counseling. The use of directives and other techniques for transparency in obstetric and neonatal care could improve the process of informed parental choice.

MeSH terms

  • Decision Making*
  • Humans
  • Infant, Extremely Low Birth Weight
  • Infant, Newborn
  • Infant, Premature*
  • Medical Futility
  • Parents / psychology*
  • Personal Autonomy
  • Quality of Life
  • Resuscitation