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Caring for the Infant With Trisomy 18: The Bioethical Implications of Treatment Decisions on Nurses

Santucci, Gina RN, MSN, FNP-BC; Battista, Vanessa RN, MS, CPNP; Kang, Tammy I. MD, MSCE

Journal of Hospice & Palliative Nursing: October 2014 - Volume 16 - Issue 7 - p 388–393
doi: 10.1097/NJH.0000000000000095
Ethics Series
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Infants born with trisomy 18 have multiple congenital abnormalities and shortened life spans. Advances in medical and surgical technology have provided some families with choices to optimize care. Given the differing outcomes that exist for infants born with trisomy 18, several questions are raised that carry weighty ethical implications. A case study will be discussed to illustrate the ethical dilemmas that nurses encounter when caring for infants with Trisomy 18. These dilemmas include the following: (1) When is it ethical to limit options offered for medical interventions? (2) Who makes decisions when options for medical interventions are considered futile? (3) What principles guide decisions about care? (4) What options are available to nurses when they do not agree with family members about suffering?

Gina Santucci, RN, MSN, FNP-BC, is family nurse practitioner, Pediatric Advanced Care Team (PACT), The Children’s Hospital of Philadelphia, Pennsylvania.

Vanessa Battista, RN, MS, CPNP, is pediatric nurse practitioner, Pediatric Advanced Care Team (PACT), The Children’s Hospital of Philadelphia, Pennsylvania.

Tammy I. Kang, MD, MSCE, is medical director, Pediatric Advanced Care Team (PACT), The Children’s Hospital of Philadelphia, Pennsylvania.

Address correspondence to Vanessa Battista, RN, MS, CPNP, Pediatric Palliative Advanced Care Team (PACT), the Children’s Hospital of Philadelphia, 34th and Civic Center Blvd, 11NW90, Philadelphia, PA 19104 (battistav@email.chop.edu).

The authors have no conflicts of interest to disclose.

© 2014 by The Hospice and Palliative Nurses Association.