Parental Voices in the Sea of Neonatal Ethical Dilemmas

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Abstract
Ethical debate in neonatal intensive care centers around the lower limits of viability, the use of multiple invasive procedures, and the role of paternalism. The parents' perspective has been addressed infrequently. This report will focus on the parents' statements as obtained through predischarge in-depth interviews with 32 families, each with a high-risk infant(s). Discussion will include a summary of the range of parental perceptions during two major periods of time: preadmission to the NICU and the NICU experience itself. Some possible nursing implications will be drawn that reflect a sensitive response to these parental perceptions. A review of parental perceptions from conception to the high-risk nursery experience shows a variety of responses in relation to the potential ethical problems. This discussion indicates that the process can be a highly stressful, strongly emotional series of events for these parents. The parental focus appears to be targeted on the pregnancy and birth experiences, prior to the discharge of the infant from the NICU. Investigations of later parental perceptions of ethical decision-making in the neonatal nursery are scheduled for the post-discharge period. These reflections will provide evidence for comparison with earlier discussions and development of themes in the parental perspective over time.

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