Chapter 4 Who should decide for critically ill neonates and how?

This chapter distinguishes between essential features of the zone of parental discretion and the longstanding concept of a grey zone in neonatal treatment decision-making. The grey zone has traditionally described a gestational age range where the outcomes of medical treatment for newborn infants ar...

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Main Author: Wilkinson, Dominic
Format: Online
Language:English
Published: The Federation Press 2021
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Online Access:1001594
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author Wilkinson, Dominic
author_browse Wilkinson, Dominic
author_facet Wilkinson, Dominic
author_sort Wilkinson, Dominic
collection Directory of Open Access Books
description This chapter distinguishes between essential features of the zone of parental discretion and the longstanding concept of a grey zone in neonatal treatment decision-making. The grey zone has traditionally described a gestational age range where the outcomes of medical treatment for newborn infants are uncertain, and therefore parents have discretion to choose between resuscitation or palliative care options. In contrast, the ZPD refers to a space where parents may make decisions for their child (not restricted to newborns) even if their decisions conflict with the decisions a clinician would make. A key difference between the two zones is that the boundaries of the grey zone are defined on the basis of published evidence about medical outcomes, whereas the boundaries of the ZPD are based on the broader but arguably vaguer notion of harm to the particular child. The grey zone has usually been defined in terms of gestational age. Wilkinson argues instead for a prognosis-based grey zone in neonatal treatment decision-making, which incorporates a range of prognostic factors rather than focusing solely on gestational age.
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spelling doab-20.500.12854ir-277042025-07-21T15:58:04Z Chapter 4 Who should decide for critically ill neonates and how? Wilkinson, Dominic Neonates ill decisions thema EDItEUR::M Medicine and Nursing thema EDItEUR::M Medicine and Nursing This chapter distinguishes between essential features of the zone of parental discretion and the longstanding concept of a grey zone in neonatal treatment decision-making. The grey zone has traditionally described a gestational age range where the outcomes of medical treatment for newborn infants are uncertain, and therefore parents have discretion to choose between resuscitation or palliative care options. In contrast, the ZPD refers to a space where parents may make decisions for their child (not restricted to newborns) even if their decisions conflict with the decisions a clinician would make. A key difference between the two zones is that the boundaries of the grey zone are defined on the basis of published evidence about medical outcomes, whereas the boundaries of the ZPD are based on the broader but arguably vaguer notion of harm to the particular child. The grey zone has usually been defined in terms of gestational age. Wilkinson argues instead for a prognosis-based grey zone in neonatal treatment decision-making, which incorporates a range of prognostic factors rather than focusing solely on gestational age. 2021-02-10T12:58:18Z 2018-10-02 09:36:37 2020-04-01T12:21:39Z 2016 chapter 1001594 OCN: 1076629984 http://library.oapen.org/handle/20.500.12657/28368 https://directory.doabooks.org/handle/20.500.12854/27704 eng open access image/jpeg image/jpeg image/jpeg image/jpeg image/jpeg n/a n/a n/a n/a n/a https://library.oapen.org/bitstream/20.500.12657/28368/1/ch4.pdf https://library.oapen.org/bitstream/20.500.12657/28368/1/ch4.pdf https://library.oapen.org/bitstream/20.500.12657/28368/1/ch4.pdf https://library.oapen.org/bitstream/20.500.12657/28368/1/ch4.pdf https://library.oapen.org/bitstream/20.500.12657/28368/1/ch4.pdf The Federation Press f6ea2379-4fba-4aa2-b9a1-10a7615aba4e When Doctors and Parents Disagree Wellcome Trust Wellcome 19 Sydney open access
spellingShingle Neonates
ill
decisions
thema EDItEUR::M Medicine and Nursing
thema EDItEUR::M Medicine and Nursing
Wilkinson, Dominic
Chapter 4 Who should decide for critically ill neonates and how?
title Chapter 4 Who should decide for critically ill neonates and how?
title_full Chapter 4 Who should decide for critically ill neonates and how?
title_fullStr Chapter 4 Who should decide for critically ill neonates and how?
title_full_unstemmed Chapter 4 Who should decide for critically ill neonates and how?
title_short Chapter 4 Who should decide for critically ill neonates and how?
title_sort chapter 4 who should decide for critically ill neonates and how
topic Neonates
ill
decisions
thema EDItEUR::M Medicine and Nursing
thema EDItEUR::M Medicine and Nursing
topic_facet Neonates
ill
decisions
thema EDItEUR::M Medicine and Nursing
thema EDItEUR::M Medicine and Nursing
url 1001594
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