Ethical Dilemmas in the Management of Infants with Necrotizing Enterocolitis Totalis
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In brief
In brief
Case-based discussion of ethical challenges in managing NEC totalis, a severe form of necrotizing enterocolitis affecting the entire neonatal intestine. Provides framework for clinical decision-making and family communication when outcomes are uncertain or poor, addressing considerations for both providers and families.
Written by the GCMD Library team from the article.
Purpose
Necrotizing enterocolitis (NEC) totalis is a devastating disease of the newborn intestine. A precise clinical definition of the extent of gastrointestinal involvement is lacking in the existing literature, and the clinical outcomes are typically viewed as grim.
Methods
Herein, we present a series of clinical case examples of patients with varying degrees of NEC totalis and other co-morbid conditions, with possible anticipated outcomes based on current data.
Results
We define the key ethical issues and provide a framework and discussion of the ethical issues involved in the care of patients with NEC totalis and recommendations of how to approach discussions with the family of these patients We discuss the ethical considerations for both the providers caring for these patients, and the patient's family members.
Conclusion
The management of patients with NEC totalis is complex and ethically challenging.