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Deciding for imperilled newborns: medical authority or parental autonomy?
  1. Hazel E McHaffie,
  2. Ian A Laing,
  3. Michael Parker,
  4. John McMillan
  1. University of Edinburgh, Simpson Memorial Maternity Pavilion, Edinburgh, Oxford Radcliffe Hospitals Trust, Oxford and University of Oxford


    The ethical issues around decision making on behalf of infants have been illuminated by two empirical research studies carried out in Scotland. In-depth interviews with 176 medical and nursing staff and with 108 parents of babies for whom there was discussion of treatment withholding/withdrawal, generated a wealth of data on both the decision making process and the management of cases. Both staff and parents believe that parents should be involved in treatment limitation decisions on behalf of their babies. However, whilst many doctors and nurses consider the ultimate responsibility too great for families to carry, the majority of parents wish to be the final arbiters. We offer explanations for the differences in perception found in the two groups. The results of these empirical studies provide both aids to ethical reflection and guidance for clinicians dealing with these vulnerable families. They demonstrate the value of empirical data in the philosophical debate.

    • Empirical ethics
    • treatment limitation
    • parental autonomy
    • decision making

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    • Hazel E McHaffie, PhD, is Research Fellow in Medical Ethics at the University of Edinburgh, and Deputy Director of Research in the Institute of Medical Ethics. Ian A Laing, MD, is Consultant Neonatologist and Clinical Director in the Simpson Memorial Maternity Pavilion, Edinburgh. Michael Parker, PhD, is Clinical Ethicist, Oxford Radcliffe Hospitals Trust and Lecturer in Medical Ethics, University of Oxford. John McMillan, PhD, is Junior Research Fellow, The Oxford Centre for Ethics and Communication in Health Care Practice, (Ethox), University of Oxford.

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