[25 years of work: The Interdisciplinary Team for Fetal Malformation at the Institute of Mother and Child in Warsaw - from counselling to clinical ethics]

Dev Period Med. 2019;23(4):246-252. doi: 10.34763/devperiodmed.20192304.246252. Epub 2021 Jan 29.
[Article in Polish]

Abstract

Perinatology is a dynamically developing field of medicine. The progress of technology in recent decades has made it possible to recognize birth defects very early, including those which are lethal or genetically determined. In many clinical situations, it is no longer possible to work alone to reach a definitive diagnosis, plan treatment or predict the clinical course of the affected fetus/newborn. There is a need for teamwork, which ensures the proper, early care starting in the fetal period, not only in the delivery room or NICU. This paper discusses the ethical foundations of creating interdisciplinary teams, taking as an example the Interdisciplinary Team for Fetal Malformation at the Institute of Mother and Child in Warsaw, which has been active for 25 years, and presents how it works in practice. On the basis of the clinical cases that are examined, practical guidelines were formulated for both the work of medical teams and the way parents are informed about the clinical situation of their child and about sharing the care after the birth of the child. A document was also proposed with information on prenatal diagnosis, decisions made by the interdisciplinary team regarding the mother and child, as well as the conclusions resulting from discussions with parents.

Keywords: birth defects; clinical ethics; interdisciplinary teams; perinatal palliative care.

MeSH terms

  • Abnormalities, Multiple / therapy
  • Congenital Abnormalities / therapy*
  • Cooperative Behavior
  • Ethics, Clinical*
  • Female
  • Health Plan Implementation / ethics
  • Humans
  • Infant, Newborn
  • Interdisciplinary Communication*
  • Patient Care Team / ethics*
  • Poland
  • Pregnancy
  • Prenatal Care / ethics*
  • Societies, Medical / ethics