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Das frühgeborene Kind im Zentrum des Entscheidungsprozesses

  • The premature baby in the decision-making process. Introduction. Decision-making concerning withholding or withdrawing of life-sustaining treatment for premature children at the border of viability is difficult and feared. Many articles are focusing these difficulties and burdening factors (e.g. Austin et al. 2009; Bucher et al. 2018; Webb et al. 2014). Nevertheless there are experienced nurses who narrate cases of decision-making processes which were reflected as well done. Often the supportive factors and values that enable a team to perform a good process are not explicit, but part of the tacit knowing of the “moral community”, as Walker (1993) named it. This investigation was undertaken to make these factors and values accessible. Method. Documentary Method applied to the interpretation of narrative interviews, as developed by Nohl (2005), was used to reconstruct social reality. 24 narrative interviews were sequential and comparative analyzed and semantically interpreted. Then, the Care-Ethic Model (Tronto 1993, 2013) was tested for it´s fitting to the reconstructed moral practice. Results. Decision-making processes which are reflected as well done have at least two important characteristics: (1) Collaborative decision making (not only shared decision-making) is needed, with building a kind of temporarily companionship and putting the different knowing, the different kind of concernment and the different perspectives into account and not only respect it but use it as a resource. (2) Everybody should focus the premature child in the center of the decision-making process as a fellow human and take her/ him as the protagonist of the process: By taking the child’s reactions and signals as serious and important information about vitality and live will, the companions on their way through this process reach more certainty. Conclusion. The Care Ethic framework amended by adding the anthropology of children as Janusz Korczak (1983, 2015) developed and practiced it in his “Pedagogic of Respect to the Child” (Beiner 2016), enables to understand the moral practice of actors in Neonatal Intensive Care.

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Verfasserangaben:Maria Peters
Gutachter*in:Helen Kohlen, Frans Vosman
Betreuer:Helen Kohlen
Jahr der Fertigstellung:2019
Datum der Erstveröffentlichung:20.03.2019
Titel verleihende Institution:Philosophisch-Theologische Hochschule Vallendar
Datum der Abschlussprüfung:20.03.2019
Datum der Freischaltung:20.03.2019
Freies Schlagwort / Tag:Entscheidungsprozess; Frühgeborene; Moralischer Status
Decision-making; Premature baby
GND-Schlagwort:Frühgeburt; Entscheidungsfindung; Ethics of Care; Emotion; Achtung
DDC-Sachgruppen:600 Technik, Medizin, angewandte Wissenschaften / 610 Medizin, Gesundheit
Zugriffsrecht:Frei zugänglich
Hochschulen:Philosophisch-Theologische Hochschule Vallendar
Lizenz (Deutsch):License LogoCreative Commons - CC BY-NC-ND - Namensnennung - Nicht kommerziell - Keine Bearbeitungen 4.0 International