Physician attitudes in Romania toward withholding and withdrawal of intensive care for infants with very poor prognosis.

OBJECTIVE

The purpose of this study was to examine the attitudes of Romanian physicians toward withholding and withdrawing intensive care for infants whose prognosis is very poor.

METHODS

A survey tool was developed by the authors and completed by participants in the annual meeting of the Neonatology Association of Romania.

RESULTS

The majority of respondents attempt resuscitation of all live-born infants, have never stopped resuscitation at birth while the infant was still alive, and have never stopped respiratory support because of poor prognosis. Nearly all respondents were uncomfortable talking with parents about withholding or withdrawing intensive care, and they were also uncomfortable talking to the parents about the death of their infant.

CONCLUSIONS

Romanian physicians are uniformly reluctant to withhold or withdraw intensive care for infants, even those with very poor prognosis. In addition, physicians are very uncomfortable talking with parents about limiting or stopping support and talking about the death of an infant. Educational programs targeting the communication of difficult topics with parents have the potential to decrease the discomfort experienced by physicians in conversing with parents about their child's poor prognosis or death.