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"Classification Guidelines Concerning Infants Born with Congenital Diseases: Ambiguous, Inflexible & Severe"

SAKURAI Hiroko

last update: 20151225


Classification Guidelines Concerning Infants Born with Congenital Diseases: Ambiguous, Inflexible & Severe

SAKURAI Hiroko
Abstract:
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
REV: 20151225
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