End-of-Life Decision-Making for Severely Ill Newborns

Abstract

Advances in neonatology enabled significant improvements in neonatal survival, often at the expense of long-term morbidity. End-of-life decisions concern neonatal patients with fatal congenital anomalies, severe neurological deficits, and extreme prematurity at the limits of viability, presenting a complex issue for both healthcare professionals and parents. Since newborns cannot express their wishes or claim their rights, physicians and parents carry the responsibility to decide in their best interests, considering their future quality of life. Harmonization of scientific progress and legislation defining clear rules is necessary so neonatologists can proceed to such agonizing decisions. Greece lacks both specific legislation regarding such decisions and medical training on handling respective ethical dilemmas. Thus, guidelines improving such decisions are closely related to the quality of the healthcare system and should be established along with the legal system's adaptation.