Parents Bill of Rights

There are many dilemmas in the Neonatal Intensive Care Unit, and many debates and arguments over the rights of premature neonates. These arguments include whether the doctor’s or the parent’s have the right to the final say regarding the care of the neonate. According to the NICU Parents Bill of Rights, parents have the right to make decisions on behalf of the infant. On the other hand, the Basic Principles of Infants Rights says the neonate has the right to life, as well as the hospital laws that states doctors now have the right to save neonates born at 24 weeks of age, weighing more than 500 grams.

This paper will not only discuss the ethical issues and dilemmas in the NICU, but also the conversations key importances on such topics.

Everybody has the right to live, in fact infants born of at least 24 weeks weighing more than 500 grams have the right to life. Although there may not be hope for the child parent’s may still request the care that their child deserves. According to the Neonatal Intensive Care Unit Parents Bill of Rights, the opening statement informs us how the parent’s are the neonates voice and their best advocate, which plays part as a plea to include the parent’s as much as possible. Whether it be including thm during visiting hours for cuddling, feeding, assisting in care if possible, also informing them and making sure they understand, and also including their voice when it comes to making decisions for the neonates care. Another part of the NICU Parents Bill of Rights also reveals that the parents have the right to know all about the neonate, also indicating they have access to all the records and any questions the parent’s may have should be encouraged.

The case of Sidney Miller is very popular and common when it comes to the discussion of extremely premature neonates with parents who refuse care for their child, for whatever reason. Are doctors obligated to abide by parent’s request or are parents liable to sue if care is provided against their request? Which brings us to another common part of the 2004 Sidney Miller case, the doctor’s continued care and since this was against the parents request, the parents decided to sue. This was a case in which the parents in fact won.

Before physicians jump head-first and try to start decoding the major dilemmas in neonatal care and the Neonatal Intensive Care Unit, they must first began to understand the key aspects of the dilemmas, the impotantants that must be taken into consideration before making decisions. One of the most essential things they must keep in mind, know, and have an understanding of is the weight of the neonate, which helps to indicate and help confirm their right to life. There must also be an understanding of the treatment needed, the proposed plan, the expected outcome, the possibility of obstacles, and any side effects that may occur, all of which should be communicate to and understood by the parent. From the point of care until discharge, and in some cases after discharge, parents should be well informed, included, and educated on their neonates condition. This also includes the way to provide proper care, the steps the parents may need to take, and any future treatment that may be needed. In any situation such as this, physicians also have to keep in mind the different laws and rules of who has the final say, legally, the rules that are proposed by the hospital ethics committee, and under what conditions these laws and rules apply.

Physicians must also keep in mind the living conditions or background of the parents, which also plays a major role in the final decision the parents makes, which acts a major factor. Some of these conditions may include their religion and beliefs, their financial status, their level of knowledge, and also including their age and level of wisdom, and capabilities of making such decisions. Sometimes it is forgotten that all these things are important and why they are important. For example, if dealing with teenage parents, who maybe have no form of parental guidance, they may not be fully capable of making drastic decisions. In cases like this, the parents are more than likely unemployed or not obtaining enough money to pay major hospital bills. These conditions may cause them to indeed refuse care for the baby. Another example may be a homeless mother with no family, but she doesn’t choose adoption because her baby is all she has. This mother may also deny major care because she can not afford it. By keeping this in mind, it allows physicians to gain an understanding and to make decisions that are in the best interest for the parents and also what is best for the child.

The Basic Principle of Infant’s Right has seven rules based for infants from birth until three years of age, otherwise known as the first section. The first rule states that because the infant has an immaturity physically and mentally and since their entire existence is based upon absolute dependence of someone else, they are obligated to special care, including any protection legally. The second law states that caregiving relationships are vital and infants need them for human development. It also implies that recognition of the infants relationship-based attachment behavior should be educated and communicated to the parent. The third law states that when the infant is born he/she is considered a citizen and should be treated as such. This means they have equal value of life regardless of gender, race, and disability. The fourth rules states that the infant has the right to proper and normal development, safety, sleep, nutrition, and love. The fifth rule states the infant has the right to be protected and shielded from abuse, physically, mentally, and sexually. This includes protection from neglect and infant trafficking. The sixth rule states that the infants have the right to professional help and care if needed, including as a result to traumatic events. The final rule in the section states that infants who are faced with life-ending conditions are guaranteed access to care that improves the quality of life for the patients and also their families, based off the same standards set for anybody else. This rule becomes very important when the conversation of End of Life Considerations come around. Set under these laws the infants are protected. They have basic human rights since birth just as we do. They deserve the right to life and care just as anyone else.

End of Life Considerations come around when physicians have done all they could do but the patient is not responding to treatment. At this point it is communicated to the child’s parent(s) by the physician, the condition of he/ she. It is then decided what is in the best interest for the child. In some cases it may be encouraged by the physicians that parents start preparing for the passing of the child. In other cases parents may request bonding time with the child before officially “pulling the plug.” At times such as these the parents are accommodated by hospital staff and it is seen that they are as comfortable as possible through this rough time.

This is referred as palliative care. Palliative focuses on providing pain relief for the patient while also relieving any stress, mentally and physically, from the patients or family. Palliative care is the option that allows for comfort care to be provided to ensure that the patients last days are comfortable, that they are not in pain, and that their family is being well taking care of. Palliative care is a way to make a stressful and rough time, as such, a little better and not as difficult.

As inferred, parents and physicians share the final say, in a way. The decision to care should be a result of teamwork that consisted of proper communication and a complete understanding from both parties, throughout the whole process. All decisions and actions of the child’s care should also be decided because of what is best for the child, as protected under his/her rights. In conclusion, the neonate is protected under several laws regardless of gender, race and disability, they also have a right to live.  

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