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8 Core Ethics Vol. : - Volpe,..,, NICU NICU : -. American Academy of Pediatrics, Committee on Bioethics,, Guidelines on Forgoing Life-Sustaining Medical Treatment, Pediatrics, : -.,, Ethics and the Care of Critically Ill Infants and Children, Pediatrics, ( ) : -. Duff, Raymond S,, Guidelines for Deciding Care of Critically Ill or Dying Patients, Pediatrics, : -.,,,, -. Duff, Raymond S, and Campbell, A.G.M,, Moral and Ethics Dilemmas in the Special-care Nursery, The New England Journal of Medicine, ( ) : -.,, ( ) : -.,, NICU Neonatal care ( ) : -.,, ( ) : -.,, ( ) : -

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10 Core Ethics Vol..,, ( ) : -.,, ( ) : -. Volpe, Joseph J,, Neurology of the Newborn rd ed, Philadelphia: W.B Saunders.,, NICU : -.,, NICU : -...,.., Class A Class B Class C Duff, Raymond S,,. A B C D [E] epidermolysis bullosa congenital myopathy trisomy trisomy,.

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13 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 s, but the guidelines themselves have not brought clarity but confusion, because ) the term guideline has been used ambiguously, ) diseases have been classified in a way that allow little flexibility for treating individual cases and ) 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 s and s, 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. 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

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Core Ethics Vol. -

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