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Arch Dis Child Fetal Neonatal Ed 2001;84:F125-F128 ( March )

Follow up care of bereaved parents after treatment withdrawal from newborns

H E McHaffiea, I A Laingb, D J Lloydc

a Medical Ethics, Department of Medicine, University of Edinburgh, Edinburgh, Scotland, UK, b Neonatal Unit, Simpson Memorial Maternity Pavilion, Edinburgh, c Aberdeen Maternity Hospital, Aberdeen, Scotland, UK

Correspondence to: Dr McHaffie, Medical Ethics, Department of Medicine, University of Edinburgh, Royal Infirmary, Lauriston Place, Edinburgh EH3 9YW, Scotland, UK hazel.mchaffie{at}ed.ac.uk

Accepted 9 October 2000

OBJECTIVE---To explore parents' experiences of bereavement care after withdrawal of newborn intensive care.
DESIGN---Face to face interviews with 108 parents of 62 babies born over two calendar years in the East of Scotland.
RESULTS---Only 22% were seen by six weeks after the death, 10% were not recalled before 6-11 months, and 8% were not seen at all in the first year. All except one couple saw the neonatologist who had cared for their baby. Only 33% remembered a neonatal nurse being present. Most (88%) were seen in the study hospital. Parents highlighted a number of specific needs. Appointments should be: (a) scheduled soon after the death of the baby and certainly within two months of the death irrespective of whether or not autopsy results are available; (b) with the named neonatologist; (c) in a setting away from the hospital if possible. Parents value: (a) efforts to find out how they are coping; (b) full frank information given sensitively to enable them to build up a cohesive picture of what happened and assess their future risks; (c) reassurance where possible, but half truths, false reassurances, and broken promises are unacceptable.
CONCLUSIONS---Follow up care is a crucial part of the management of families from whose babies treatment has been withdrawn. Resources devoted to it should be re-examined to provide a service more in tune with parental need. In choosing the place, timing, and conduct of the meeting, staff should be sensitive to the expressed wishes of the parents themselves.


Keywords: follow up; treatment withdrawal; bereaved parents; neonatal


© 2001 by Archives of Disease in Childhood



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