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End of life decisions as bedside rationing: An ethical analysis of life support restrictions in an Indian neonatal unit

Posted Aug 11 2010 7:23am
In the latest issue of the Journal of Medical Ethics , Ingrid Miljetegeig and colleagues discuss "End of life decisions as bedside rationing. An ethical analysis of life support restrictions in an Indian neonatal unit."  


India lacks the capacity to provide services to all the premature neonates that need intensive care.  850,000 infants born in India each year are born between gestational week 32.  There are beds for fewer than 4.0% of those that need them.  Neonates born before 28 weeks "almost never received treatment," is a much higher threshold than in the United States.  Neonates born after 32 weeks "typically received initial treatment."  The focus of the authors' discussion is on the neonates born between 28 and 32 weeks.  The analysis is interesting because it is so capacious.  The authors examine not just the benefits and burdens to the child but also benefits and burdens to (1) parents and family, (2) other patients, (3) healthcare providers, (4) the hospital, and even (5) society.

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