Postponed Withholding: An Ethical Tool for Health Care Personnel to Empower Parents

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This article refers to:

Postponed Withholding: Balanced Decision-Making at the Margins of Viability

Informed Nondissent at the Limits of Viability

The Path More Easily Reversed: Postponed Withholding at Borderline Viability

Deferring Decision-making in the Face of Uncertainty

Delayed Withholding: Disguising Withdrawal of Life Sustaining Interventions in Extremely Preterm Infants

The Postponed Withholding Model: An Autoethnographic Analysis

Should We Aspire to Be Rational About Letting Babies Die?

The Birth of Tragedy? Extremely Premature Births and Shared Decision-Making

Embrace the Gray: How Tackling the Clinical Complexities of the Gray Zone Will Improve Decision-making

Postponed Withholding Does Not Postpone Attachment

Default Withdrawal: Exacerbating Mistrust for Our Most Vulnerable Families

What Is the Ethical Goal of Empowering Parents in Emergent Decision-making about Their Premature Newborn?

Postponed Withholding: Harmful for the Infant and Increasing the Complexity of Decision-Making

Use Certified Patient Decision Aids to Facilitate Shared Decision Making at the Margins of Viability

Postponed Withholding: The Wrong Nudge

Notes

1 Parents who feel prepared to make that decision together with HCP, should definitively be given the opportunity to forego life support at birth, and be assured that this is within what a good and loving parent would do, the same goes if they express that they want a trial of life support. As stated in our article, the time needed is highly individual: “some well-prepared parents will know what is right for them upon arrival at the hospital while others may need several days.” Some may never want to make such decision, but hand it over to HCP.

2 We reiterate that the definition and boundaries of the periviable gray zone within a society should be consistent and transparent, and should be determined by relevant stakeholders through an open process.

Additional information

Funding

This work was supported by The Liaison Committee between the Central Norway Regional Health Authority and the Norwegian University of Science and Technology, Trondheim, Norway [SO: 90278900b].