Abstract
In the current neonatal medicine, medical decision making from ethical point of view is essential for proper care of the infants with a poor prognosis. In our institute, classification of the patients according to severity of their prognosis is established as follow : class A ; provide all possible treatment. class B ; limit invasive treatment such as major surgery, hemodialysis. class C ; observe with current treatments and routine care such as temperature control, enteral nutrition, skin care, with tenderness. class D ; discontinue all treatments. After discussions with all staff members involving the care of the patient, the most senior staff member makes the final decision, while considering family's will and wish. Patient with trisomy 18 is usually classified into class C because of its very short life expectancy, especially when the patient has lethal malformation. However, we experienced a long-term survived case with trisomy 18 who was under medical treatment for cardiac failure but lived a happy life with the family at home. Accordingly, we should not draw a conclusion from the diagnosis only, but with the medical and familial difference of each case.
