End-of-life decisions in Dutch neonatal intensive care units

Despite the rapid technical innovations in neonatology, a considerable proportion of newborns still die shortly after birth. The death of many of these infants is often preceded by an end-of-life decision. End-of-life decisions are medical decisions with the effect or the probable effect that death is caused or hastened. They include the decision to withhold or withdraw life-sustaining treatment, as well as the decision to deliberately end a newborn’s life with lethal drugs.

Neonatal end-of-life decision-making is one of the most controversial areas of medicine as it raises all kinds of medical, ethical and legal questions regarding clinical management of severely ill newborns. End-of-life decisions in Dutch neonatal intensive care units examines these questions and provides a description of end-of-life decision-making practice in the Netherlands based on empirical studies by the author and his colleagues.

The first part of the book covers physician’s end-of-life decision-making considerations, including those leading to deliberate termination of life, the role of the parents and the use of medication as a part of end-of-life decisions. The last section covers a comparison of end-of-life decision-making in four NICU’s in the USA, Canada and the Netherlands followed by a reflection on the key aspects of Dutch neonatal end-of-life decision-making.