Treatment Choice for Infants in the Neonatal Intensive Care Unit at Risk for AIDS
Levin, Betty Wolder
Driscoll, John M.
Fleischman, Alan R.
JAMA. 1991 Jun 12; 265(22): 2976-2981.
Many infants admitted to neonatal intensive care units are the children of women infected with the human immunodeficiency virus (HIV); they have approximately a 30% risk of infection. To investigate attitudes surrounding treatment for such newborns, we conducted a survey of professionals at six neonatal intensive care units in New York City. A significant proportion of the 247 respondents recommended less aggressive treatment for non-HIV related conditions for infants at risk for HIV compared with those not at risk. For example, 97% of respondents recommended open heart surgery for an infant with no known HIV risk but only 77% recommended surgery for an infant whose mother had acquired immunodeficiency syndrome; if certain the infant was infected, 42% of respondents recommended surgery. We conclude that perceived HIV status may influence decision making about treatment for non-HIV-related conditions for critically ill patients, including infants not actually infected. Ethical issues concerning the relevance of HIV status need to be examined.
Aids; Aids Serodiagnosis; Allowing to Die; Artificial Feeding; Attitudes; Acquired Immunodeficiency Syndrome; Children; Clinical Ethics; Clinical Ethics Committees; Congenital Disorders; Critically Ill; Decision Making; Diagnosis; Ethics; Ethics Committees; Evaluation; Evaluation Studies; HIV Seropositivity; Hospitals; Infants; Intensive Care Units; Life; Mass Screening; Minors; Mothers; Newborns; Patient Care; Patients; Physicians; Pregnant Women; Prematurity; Prognosis; Quality of Life; Renal Dialysis; Resuscitation; Resuscitation Orders; Risk; Selection for Treatment; Surgery; Survey; Uncertainty; Withholding Treatment;
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