Physicians and nurses’ perspectives of encountering neonates with poor prognosis

Abstract Introduction: Decision making regarding the treatment of neonates with poor prognoses is difficult for healthcare staff working in the neonatal intensive care unit (NICU). This study aimed to investigate the attitude of physicians and nurses towards the value of life and ethical decision making when encountering neonates with poor prognosis in the NICU. Methods: A cross-sectional study was conducted in 2016. This study was carried out in five NICUs of five hospitals in Tehran city, Iran. The perspectives of 144 paediatricians, gynaecologist and nurses were assessed using the questionnaire of attitude toward the value of life and agreement on intensive care management on three hypothetical cases scenarios of neonates with poor prognosis. Data was analysed using descriptive and inferential statistics. Results: The negative agreement on the no initiation of intensive care measures and the discontinuation of resuscitation in neonates with poor prognosis was more than the positive agreement. Also, various factors influenced the participants’ decision making for the provision of care to neonates. Regarding the case scenarios, the participants agreed on the provision of aggressive, conservative, and palliative care with various frequencies. This study confirms the importance of healthcare providers’ perspectives and their impacts on ethical decision making. The participants in this study favoured the value or sacredness of life and agreed on the use of all therapeutic measures for neonates with poor prognosis. Conclusion: More studies are required to improve our understandings of factors influencing ethical decision makings by healthcare providers when encountering neonates with poor prognosis in NICUs. Key words: Decision making, ethics, neonatal intensive care unit, poor prognosis, value of life