Reality to a medical ethical decision-making and the factor of nurses’ participation in NICU: Consideration of the role of nurses

Abstract

 We investigated a questionnaire survey to clarify the reality of medical ethical decision-making, the reality of nurses’ participation, and factors related to nurses’ participation. 1. There were 29 target diseases including very low birth weight, trisomy 18, and severe neonatal asphyxia. Furthermore, it was revealed that families do not participate in decision-making and sometimes are not subject to the decisions. 2. Nurses understood well that decision-making concerned the condition of the child, but “the hope of parents” affected the decision about the treatment of the child. 3. Of all nurses surveyed, 26.1% had experienced participating in decision-making. Factors related to participation were recognition of “classification of Tokyo Women’s Medical University” and “guidelines of Yodogawa Christian Hospital.” Based on the above results, the required roles of nurses are 1. to provide information for the family to become the decision-making entity to support the decision-making process by listening to their thoughts, 2. to make decisions from the position of children, and 3. to construct a learning system as an organization in order for the nurses themselves to participate in decision-making.