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Rationing potentially inappropriate treatment in newborn intensive care in developed countries
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Wilkinson, Dominic, Petrou, Stavros and Savulescu, Julian (2018) Rationing potentially inappropriate treatment in newborn intensive care in developed countries. Seminars in Fetal and Neonatal Medicine, 23 (1). pp. 52-58. doi:10.1016/j.siny.2017.10.004 ISSN 1744-165X.
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Official URL: https://doi.org/10.1016/j.siny.2017.10.004
Abstract
In newborn intensive care, parents sometimes request treatment that professionals regard as ‘futile’ or ‘potentially inappropriate’. One reason not to provide potentially inappropriate treatment is because it would be excessively costly relative to its benefit. Some public health systems around the world assess the cost-effectiveness of treatments and selectively fund those treatments that fall within a set threshold. In this paper, we explore the application of such thresholds to decisions in newborn intensive care, to explore: (1) when a newborn infant’s chance of survival is too small; (2) how long treatment should continue; (3) when quality of life is too low and (4) when newborn infants are too premature for cost-effective intensive care. This analysis yields some potentially surprising conclusions. Newborn intensive care may be cost-effective even in the setting of very low probability of survival, quality of life, for protracted periods of time or for the most premature of newborns.
Item Type: | Journal Article | ||||||||
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Subjects: | R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services | ||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Neonatal intensive care -- Cost effectiveness, Medical ethics -- Economic aspects | ||||||||
Journal or Publication Title: | Seminars in Fetal and Neonatal Medicine | ||||||||
Publisher: | Elsevier | ||||||||
ISSN: | 1744-165X | ||||||||
Official Date: | February 2018 | ||||||||
Dates: |
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Volume: | 23 | ||||||||
Number: | 1 | ||||||||
Page Range: | pp. 52-58 | ||||||||
DOI: | 10.1016/j.siny.2017.10.004 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Access rights to Published version: | Restricted or Subscription Access | ||||||||
Date of first compliant deposit: | 11 September 2017 | ||||||||
Date of first compliant Open Access: | 31 October 2018 | ||||||||
RIOXX Funder/Project Grant: |
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