Dutch pediatricians' views on the use of neuromuscular blockers for dying neonates: A qualitative study

Objective:To assess Dutch pediatricians' views on neuromuscular blockers for dying neonates.Study design:Qualitative study involving in-depth interviews with 10 Dutch pediatricians working with severely ill neonates. Data were analyzed using appropriate qualitative research techniques.Result:Participants explained their view on neuromuscular blockers for neonates with a protracted dying process. Major themes were the interpretation of gasping, the role of (the suffering of) the parents, the need for judicial review and legislation's impact on the care participants provide for dying neonates.Conclusion:The interviews show no consensus between pediatricians and provide insights into the points of disagreement. Interviews also suggest friction between the convictions of pediatricians and legislation, which seems to have an undesirable impact on Dutch care for dying neonates and their parents. This study raises important questions for pediatricians worldwide to reflect upon, such as: 'what constitutes 'dying well'?' and 'what role should the parents' perspective play?'.

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