Neonatal Care and the Issue of Disclosure of Information
Journal Title: Progressing Aspects in Pediatrics and Neonatology - Year 2017, Vol 1, Issue 1
Abstract
There is little doubt that the field of Neonatology has, and is, undergoing vast clinical changes as underlying research in all its background sciencesprogresses in leaps and bounds. One has also to realise that this progress as in all medical disciplines is multi-dimensional, and far beyond the simple clinical end-point expression of progress in neonatal medicine, pharmacology and surgery. Among these dimensions, the medico-legal aspect, looms large and over the recent years, has loomed larger still. Medico-legal neonatology itself comprises many subdivisions, although here, the topic, deals with parental disclosure of medical information. It is crucial to reflect on the potential implications of failing to disclose sufficient inormation about any proposed treatment to the parents. It is just as crucial to train new neonatologists to aasume this stance de rigeur. For it does not come instinctively. It is also somewhat demoralising to reflect on the potential legal comebacks to the young neonatologist, brimming with knowledge, enthusiasm and an irrepressible will to safe the vulnerable neonate. Yet, one painful and disturbing lesson taught by medico-legal medicine is that healers who are good, well informed, updated, capable and sincere in their efforts to heal, may still have to face Court to answer for medical negligence. One way by which, such a neonatologist find himself facing a negligence claim is through insufficient or absent disclosure of information to the parents. I give one example based on the fact that in preterm infants, systemic postnatal corticosteroid therapy to prevent or treat chronic lung disease, though effective in improving lung function, may cause Cerebral Palsy. This is a delicate situation where the doctor may well feel that “doctor knows best”. In truth doctor does know best but in 2017, this is not synonymous to the fact that “hence he can administer what he wants.” The paternalistic attitude is no longer condoned by the Courts, in any aspect of medicine, if and when, a clinical situation reaches Court on a basis of alleged liability of medical negligence. Hence, in this situation, the neonatologist needs must explain to the parents why he needs to give steroids, what might happen if they are withheld, if alternatives exist, what is the known relationship to cerebral palsy.
Authors and Affiliations
George Gregory Buttigieg
Keywords
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- DOI 10.32474/PAPN.2018.01.000102
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