Newborns are unable to make their own decisions, and often, it is the parents who decide on the appropriate interventions for their newborn. In the parents’ absence, the facility must identify a surrogate to act as the newborn’s primary decision-maker.

The parents require relevant and accurate information about each treatment option’s risks and benefits to decide what interventions are appropriate for their newborn. When appropriate, they need adequate time to make an informed decision based on the information they have gathered or plan to collect. 

The parent’s decision is difficult because there is no accurate way to know if a procedure will be effective. For example, the likelihood of survival of an individual high-risk newborn is unknown until the provider gathers sufficient data. Sometimes this can take several hours to days. However, the parents must make decisions promptly based on the baby’s best interest.

A premature infant in the NICU holding parent’s hands.

The doctor must explain these uncertainties together with the initial treatment options to the newborn’s parents or surrogate decision-makers. Since the team continually adjusts treatment plans based on the newborn’s response to treatment, the parents or surrogates must be continually updated.