Hersher Institute: Module on Ethical Reasoning in Developmental Disabilities

NICU Case: Guiding Questions

  1. What is the role of the SLP/OT in supporting feeding and oral-motor development for this child?
  2. What assessments should be done to determine a feeding /nutritional plan?
  3. Depending on the results of the assessment, what treatment(s) around feeding and oral motor development could be undertaken?
  4. What is the role of the SLP/OT in supporting the mother in making a decision about ventilator removal?
  5. What ethical issues are involved in this decision? C an the ethics rubric be useful in providing support to the mother?
  6. Review the “Five NICU CASES” in the Ethical Issues section. How does this case compare with these. To which is it most/least dissimilar?

  7. Here is the reported outcome of this case:
    From the beginning, Mom X stated she did not want to be there or hold her baby when he died. She was assured her wishes would be respected by care team and that her baby would not die alone. On Day 5 of life, Baby X became increasingly acidotic, had dusky spells, and was obviously struggling to breathe. Mom X made the decision that it was time to let her baby go. Surrounded and supported by members of the perinatal care team Mom X stayed with her baby and held him until the end.
    • Do you think this was the “right” resolution? Why or why not? How do the ethical principles and rubrics discussed in class help you to come to this decision?
    • How does the work you did on this case make you think differently about newborn intensive care than you did before? How will it affect your practice?

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