Question

Explain the three proposed standards for the care of critically ill newborns, the Medical Interests Standard, Best Interests Standard, and Relational Quality of Life Standard. Which of these standards is most consistent with your own moral beliefs and why?

Answer 1

The care of critically ill newborn includes certain standards that frames a set of criteria to make decision for the newborn as he/she cannot speak for themselves. These proposed standards include Medical interest standards, Best interest standards and Relational quality of life standards. These standards help the care giver, parents or a surrogate decision maker to make appropriate decision for the child who cannot speak for himself keeping in mind the child's right.

Medical interest standard states that whether a child has a chance of survival is medical judgement but the view of parents regarding discontinuation of a treatment should be taken into account. The parents should be given adequate time to adapt themselves to the fact that further treatment will not be beneficial but continuing futile treatment will be harmful for the child whose well being is physician primary concern.

Best interest standard states that the decision about the treatment of the newborn should be based on what is considered to be the patients best interest. The patients best interest is assessed by balancing the perceived benefits and the burden of the various options being considered. The treatment option which may reduce the threshold of harm to patient is usually chosen.

The relational quality of life standard states that adequate palliative care to the newborn who is critically ill should be given. It includes the emotional, physical, social, spiritual elements that focus on enhancing the quality of life of the newborn and support for the family. It includes the management of distressing symptoms, the provision of short breaks and care during death and bereavement.

From the above standards the relational quality of life standard is considered as most consistent with my moral belief. Withdrawing the treatment as nothing more can be done is unethically according to me. As per my spiritual and moral belief there is always a scope of miracle in improvment of patient condition. Therefore providing a holistic care aiming at providing overall comfort to patient is relevant. It will not only provide the palliative care but also will prepare the parents for the process of death and bereavement.