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Beneficence and Nonmaleficence in Treating Neonatal Hypoxic-Ischemic Brain Injury

Review article
Authors M. Tagin
Changlian Zhu
A. J. Gunn
Published in Developmental Neuroscience
Volume 37
Issue 4-5
Pages 305-310
ISSN 0378-5866
Publication year 2015
Published at Institute of Neuroscience and Physiology
Pages 305-310
Language en
Links dx.doi.org/10.1159/000371722
Keywords Neonatal, Encephalopathy, Beneficence, Nonmaleficence, D-ASPARTATE RECEPTOR, MAGNESIUM-SULFATE, THERAPEUTIC HYPOTHERMIA, COMPETITIVE-INHIBITION, CHILDHOOD OUTCOMES, CEREBRAL-PALSY, BIRTH, ASPHYXIA, GLYCINE SITE, ENCEPHALOPATHY, XENON, Developmental Biology, Neurosciences
Subject categories Neurosciences

Abstract

The successful clinical translation of therapeutic hypothermia offers the tantalizing possibility that further improvements in outcomes may be possible by combining cooling with other neuroprotective drugs. The challenge now is to select from a daunting range of potential treatments. The patient's best interest must be central to ethical decision making at all times. However, the beneficence or nonmaleficence of potential therapies is seldom clear for any individual patient at the time of testing new therapies. Clinical randomized controlled trials are generally acknowledged by the scientific community as the 'gold standard' for evaluating interventions in health care. Therefore, ethical trial design is of the utmost importance. This paper explores contrasting ethical perspectives on how to select new interventions to treat neonatal encephalopathy after perinatal hypoxia-ischemia. (C) 2015 S. Karger AG, Basel

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