End-of-life decisions of doctors concerning neonates and infants.

Objectives: to study medical decision making preceding death in infants under one year of age, in view of the fact that recent technical advances in neonatal intensive care increasingly entail questions about whether application is warranted in all cases of severely ill neonates and infants.
 
Three main categories of end-of-life decisions will be researched :
1. a decision to forgo life-sustaining treatment
2. administration of potentially life-shortening drugs to alleviate pain or other symptoms
3. the administration of a drug with the explicit aim of hastening death.
 
Design: retrospective, descriptive study of all deaths under one year of age.
 
Setting: Belgium, Flanders.
 
Methods: data will be collected by :
 
a) questionnaires mailed to all doctors attending the deaths of infants under one year of age. The doctors will be identified from the death certificates sent to the Flemish Ministry of Public Health from January through December of 1999.
b) interviews with a representative sample (a selected group) of doctors : neonatologists, pediatric intensive care specialists, general pediatricians.
 
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