Dreams and Dilemmas: Parents and the Practice of Neonatal Care

The Ethics Institute, in collaboration with the Neonatal Intensive Care Unit of the Pediatrics Department at the Dartmouth-Hitchcock Medical Center, is producing a video documentary on decision-making practices in neonatal care. The video will serve to educate parents, prospective parents of premature newborns, the professional staff of the neonatal intensive care units, and the public as a whole on the ethical issues involved in the decision making process of treating premature infants.

The Greenwall Foundation has awarded a total of $171,000 to support a one-year video project on decision-making practices in neonatal care. Ronald M. Green, Director of the Institute, and George A. Little, Professor of Pediatrics, DHMC, are co-principal investigators. Richard Kahn is filmmaker.

The film's goal is to show shared decision-making by parents and caregivers in the treatment of babies with medical problems. This is a film without a script. Over the course of a year in the Intensive Care Nursery, filmmaker Richard Kahn will try to capture those moments when parents and neonatal professionals work effectively together to decide the best treatment course for a newborn. Internal and external advisory panels of professionals and parents are being set up to help guide the project.

Filming began in late March and ended in October of 1996.

Two panels of parents and professionals were formed to act in an advisory role as video production continues throughout the year. The On Site Advisory Committee, made up of neonatologists, staff nurses, hospital administrators, and others with expertise relevant to the project, meet periodically to assist the co-principal investigators and filmmaker in identifying cases and issues representing the difficult challenges posed by neonatal intensive care. As a group, this On Site Advisory Committee will play a key role in facilitating every phase of work on the film.

In addition, an External Advisory Board, made up of non-Dartmouth professionals and individuals with special interest in the project, provides additional insight as the project develops. The External Advisory Board meets twice during the project year. The On Site Advisory Committee will participate in these meetings. The first of these two larger meetings was held in May of 1996, when some initial footage was previewed. In the Spring of 1997, when a rough-cut of the video was ready, three preview meetings were held in New York, Washington, and Manchester NH for final input from the advisory board. The film was completed in the Fall of 1997 and is being distributed by Fan Light Productions. For more on information on 'Dreams & Dilemmas' click here.