Haward Marlyse F, Gaucher Nathalie, Payot Antoine, Robson Kate, Janvier Annie
Department of Pediatrics, Albert Einstein College of Medicine, The Children's Hospital at Montefiore, New York, NY 10467, USA.
Department of Pediatrics, CHU Sainte-Justine Research Center, Sainte-Justine Hospital, University of Montreal, Montreal, Quebec H3T 1J4, Canada; Clinical Ethics Unit, Sainte-Justine Hospital, University of Montreal, Montreal, Quebec H3T-1C5, Canada.
Clin Perinatol. 2017 Jun;44(2):429-445. doi: 10.1016/j.clp.2017.01.006. Epub 2017 Apr 1.
Emphasis has been placed on engaging parents in processes of shared decision making for delivery room management decisions of critically ill neonates whose outcomes are uncertain and unpredictable. The goal of antenatal consultation should rather be to adapt to parental needs and empower them through a personalized decision-making process. This can be done by acknowledging individuality and diversity while respecting the best interests of neonates. The goal is for parents to feel like they have agency and ability and are good parents, before birth, at birth, and after, either in the NICU or until the death of their child.
重点一直放在让父母参与对病情危急、预后不确定且不可预测的新生儿产房管理决策的共同决策过程中。产前咨询的目标更应该是适应父母的需求,并通过个性化的决策过程增强他们的能力。这可以通过承认个体差异和多样性,同时尊重新生儿的最大利益来实现。目标是让父母在孩子出生前、出生时以及出生后,无论是在新生儿重症监护病房还是直到孩子去世,都能觉得自己有自主权和能力,并且是称职的父母。