Baral Vijay R, Lim Yinru, Edison Priyantha, Menikoff Jerry Alan
Department of Neonatal and Developmental Medicine, Singapore General Hospital, Singapore.
Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Asian Bioeth Rev. 2025 Feb 26;17(2):237-249. doi: 10.1007/s41649-024-00337-x. eCollection 2025 Apr.
Ethical conundrums are common in neonatal medicine, particularly around continuing or withdrawing intensive treatment in a critically ill baby. A common scenario is a baby born with compromised oxygen delivery around the time of birth (perinatal asphyxia) leading to a condition named hypoxic ischemic encephalopathy (HIE) which can have a high probability of death or long-term neurologic disability. This article reviews the key ethical dilemmas that underpin the clinical management of babies with severe HIE. The discussions, however, could be relevant in any newborn with a life-threatening illness where withdrawal or redirection of intensive treatment is being considered.
伦理困境在新生儿医学中很常见，尤其是在对危重新生儿继续或停止强化治疗方面。常见的情况是，婴儿在出生前后出现氧输送受损（围产期窒息），导致一种名为缺氧缺血性脑病（HIE）的病症，这种病症很可能导致死亡或长期神经功能残疾。本文回顾了严重HIE患儿临床管理背后的关键伦理困境。然而，这些讨论可能适用于任何患有危及生命疾病且正在考虑停止或调整强化治疗的新生儿。
