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Please use this identifier to cite or link to this item: https://dspace.lboro.ac.uk/2134/21133

Title: Parental involvement in neonatal critical care decision-making
Authors: Shaw, Chloe
Stokoe, Elizabeth
Gallagher, Katie
Aladangady, Narendra
Marlow, Neil
Keywords: Neonatal
End-of-life
Critical care
Decision making
Ethics
Parents
Involvement
Conversation analysis
Issue Date: 2016
Publisher: © Wiley
Citation: SHAW, C. ... et al, 2016. Parental involvement in neonatal critical care decision-making. Sociology of Health and Illness, 38 (8), pp. 1217-1242.
Abstract: The paper analyses the decision-making process between doctors and parents of babies in neonatal intensive care. In particular, it focuses on cases in which the decision concerns the redirection of care from full intensive care to palliative care at the end of life. Thirty one families were recruited from a neonatal intensive care unit in England and their formal interactions with the doctor recorded. The conversations were transcribed and analysed using conversation analysis. Analysis focused on sequences in which decisions about the redirection of care were initiated and progressed. Two distinct communicative approaches to decision-making were used by doctors: ‘making recommendations’ and ‘providing options.’ Different trajectories for parental involvement in decision-making were afforded by each design, as well as differences in terms of the alignments, or conflicts, between doctors and parents. ‘Making recommendations’ led to misalignment and reduced opportunities for questions and collaboration; ‘providing options’ led to an aligned approach with opportunities for questions and fuller participation in the decision-making process. The findings are discussed in the context of clinical uncertainty, moral responsibility and the implications for medical communication training and guidance
Description: This paper is embargoed until September 2018.
Sponsor: Funding: National Institute of Health Research (NIHR) Programme Development Grant RG-DG-0611-10006
Version: Accepted for publication
DOI: 10.1111/1467-9566.12455
URI: https://dspace.lboro.ac.uk/2134/21133
Publisher Link: http://dx.doi.org/10.1111/1467-9566.12455
ISSN: 0141-9889
Appears in Collections:Closed Access (Social Sciences)

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