"Classification Guidelines Concerning Infants Born with Congenital Diseases: Ambiguous, Inflexible & Severe"
last update: 20151225
Classification Guidelines Concerning Infants Born with Congenital Diseases: Ambiguous, Inflexible & Severe
For infants born with congenital diseases, medical professionals face fundamental treatment dilemmas:
Should medical interventions be offered at all? To what point should the treatments be given? Treatment
guidelines for these questions were first created in Japan in the 1980s, but the guidelines themselves have not
brought clarity but confusion, because 1) the term "guideline" has been used ambiguously, 2) diseases have been
classified in a way that allow little flexibility for treating individual cases and 3) the recommendations for care
termination are often severe.
The word "guidelines" is often used in the field of neonatal medicine, but the term refers to two different sets
of recommendations. The first, made in the 1980s and 1990s, classified treatments according to diseases. The
second is the result of discussions on treatment policy by a Ministry of Health, Labor and Welfare research
group in 2003. Lack of a clear distinction between the two has lead to confusion in deciding medical treatments.
Furthermore, when guidelines based on disease classification are rigidly applied, individual patients can be
harmed by treatments that are excessive or insufficient to their personal needs or that are terminated too
abruptly, especially in the case of plastic or restorative treatments.
Keywords: classification, guidelines, infants born with congenital diseases, neonatal medicine, treatment policy