Attitude and practice of pediatrics and gynecology physicians in the cities of Sari and Babol regarding non-initiation and discontinuation of resuscitation in cases of gravely Ill newborns

Background and

There are some debates with decision making for withdrawal/ withholding of life sustaining treatment in infants with adverse prognoses and incurable conditions. This study is conducted to review attitudes and practice of pediatrics and gynecology physicians in this field.

This survey was conducted during 2009 in Sari and Babol. A total of 140 pediatricians, gynecologists and residents/fellows in these fields were recruited by census; 106 doctors completed an anonymous questionnaire (response rate 75.7%).

More than 70 percent of respondents disagreed and less than a quarter of them agreed with euthanasia. Thus far, none of the doctors prescribed drugs to expedite neonatal death. Withdrawal of life sustaining treatment in infants with adverse prognoses and incurable conditions was uncommon, and reported by one fifth of physicians in their diagnosis of infants with multiple congenital anomalies.Influential factors in their decision to withdraw life sustaining treatment in these infants were: the number of children, the insistence of hospital staff, the request from parents, the infant's sex, lack of hospital facilities, parental history of infertility and family income, respectively. Religious beliefs were effective for withdrawal/withholding of life sustaining treatment in the decision making process and was led to an agreement more with the approval of the law in the majority of cases.

This study revealed that attitude and sanctity of life, overcomes the attitude regarding to quality of life from most of the physicians. Law approval in this field is necessary.