Ethical Considerations in the Neonatal Intensive Care Unit

Lisa J. Sundean, RN, MSN, MHA; Jacqueline M. McGrath, PhD, RN, FNAP, FAAN

Disclosures

NAINR. 2013;13(3):117-120. 

In This Article

Abstract and Introduction

Abstract

Advances in treatment and technology capabilities, coupled with the ability to care for younger, smaller, and sicker neonates contribute to ethical conflicts in the neonatal intensive care unit (NICU). Although the ethical approach to care is sometimes inconsistent, it is important for clinicians to develop and adopt a framework for ethical decision-making in the NICU. Providers need to understand the four ethical principles of autonomy, beneficence, nonmaleficence, and justice and apply these principles to clinical decision-making about care in the NICU. Ethical decision-making must be family-centered and respectful of cultural differences. Providers must comply with professional ethical guidelines as well as government and legal mandates. Adopting ethical frameworks for neonatal care ensures a more holistic approach to care in the highly technical environment of the NICU.

Introduction

Advances in treatment and technology capabilities, coupled with the ability to care for younger, smaller, and sicker neonates contribute to ethical conflicts in the neonatal intensive care unit (NICU). The perspectives on ethical issues in the NICU vary and no consensus exists on a consistent approach to resolving these conflicts.[1] Clinical and ethical experts emphasize the need for a consistent framework for applying ethical principles in the NICU. This article provides an overview of ethical issues in the NICU. The four principles of ethics are described and applied to situations in the NICU environment. Recommendations for practice follow to assist nurses in developing and accessing an ethical framework for care in the NICU.

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