Guidelines for Infant Bioethics Committees

Abstract

BACKGROUND In recent years a widespread public debate has developed on issues surrounding the care and treatment of critically ill infants. One aspect of this debate concerns the procedures that should be available to ensure that difficult treatment decisions regarding such infants are always made in the most effective manner possible. The American Academy of Pediatrics believes that hospital-based "infant bioethics committees," consisting of both physicians and nonphysicians, can provide consultation and review, ensuring sensitive treatment decisions made in a reasoned, informed, and caring manner. Infant bioethics committees can provide education, develop and recommend institutional policies, and offer consultation to providers and families facing a range of ethical problems or questions about medical treatment of infants. The Academy urges all hospitals to establish such committees either on their own or in conjunction with other hospitals. This document is intended to assist those individuals and institutions who elect to engage in this process. The American Academy of Pediatrics has been involved in discussion of ethical issues surrounding the care and treatment of critically ill infants since 1982. In 1983, the US Department of Health and Human Services published regulations on this issue, establishing federal law enforcement activities which were intrusive into patient care. The Academy successfully challenged that rule in court. Subsequently, the Department of Health and Human Services issued regulations in the Federal Register (effective Feb 13, 1984, but currently in litigation) that, among other things, endorse the concept of infant review committees as suggested in comments that had been submitted by the American Academy of Pediatrics.