Thursday, February 2, 2023

Ethical Issues in Neonatal Care

Overview

Background

As neonatal medicine has progressed in the United States, the presence of clinical ethics (ie, bioethics, medical ethics, healthcare ethics) in the healthcare environment has also increased.
For nearly 70 years, neonatal medicine has been practiced to provide specialized and intensive care measures aimed at improving the health and survival of premature and critically ill newborns.

Throughout this period, great strides were made in improving the technical capabilities that allow more rapid and precise diagnoses, effective monitoring, and specific therapy. The availability of special-care nursery beds also increased dramatically, as did the number of professionals and specialists trained to care for this vulnerable population.

The results of this progress are mixed. There has been a substantial reduction in the mortality of premature infants, whereas the rate of handicap or significant morbidity appears to have remained steady or declined in survivors of the neonatal intensive care unit (NICU) for nearly all gestational ages and weights. The incidence of preterm birth in the United States decreased between 2007 and 2014 but appeared to be on the rise again in 2015.
The rate of low birth weight babies (those with birth weights <2500 g) declined. Furthermore, the rate of birth defects remains relatively constant, and infant mortality, although diminished over the past decade, remains higher in the United States than in many other developed nations. Finally, the persistent discrepancy between black and white infant mortality remains a concern.

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