Ethical issues about the paradigm shift in the treatment of children with trisomy 18
Materias Investigacion::Ciencias de la Salud::Pediatría
Trisomy 18
Palliative care
Quality of life
Interventionist approach
Issue Date: 
Silberberg, A. (Agustín); Robetto, J. (Josefina); Grimaux, G. (Guadalupe); et al. "Ethical issues about the paradigm shift in the treatment of children with trisomy 18". European Journal of Pediatrics. (179), 2019, 493 - 497
Until recently, trisomy 18 was considered a disease incompatible with life, with a high percentage of electively terminated pregnancies. The usual behavior was denial of treatment. But some medical interventions have changed the survival of children. A search for articles published in the PubMed database on the latest medical decisions in newborns with trisomy 18 was done. Two main subjects were examined: (1) the chances of survival and (2) the perception of quality of life. Trisomy 18 is no longer considered a disease incompatible with life, and the discussion has shifted towards the type of treatment that is appropriate to initiate at birth. There are two medical attitudes towards these children: either palliative care or life-prolonging interventions. With medical intervention, the survival is as high as 23% at 5 years of age. Regarding the quality of life, all decision-makers emphasize the possibility of taking the child home. The physicians’ perception is more pessimistic than that of the parents. Only a few children benefit from medical interventions. Conclusion: There is a rethinking of treatment behavior in children with trisomy 18. The possible quality of life achieved should be further investigated. It seems inappropriate to simply dismiss medical interventions.

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