Treatment choice for infants in the neonatal intensive care unit at risk for AIDS
B. W. Levin, J. M. Driscoll Jr and A. R. Fleischman
Department of Health and Nutrition Sciences, Brooklyn College, NY 11210.
Many infants admitted to neonatal intensive care units are the children of
women infected with the human immunodeficiency virus (HIV); they have
approximately a 30% risk of infection. To investigate attitudes surrounding
treatment for such newborns, we conducted a survey of professionals at six
neonatal intensive care units in New York City. A significant proportion of
the 247 respondents recommended less aggressive treatment for
non-HIV-related conditions for infants at risk for HIV compared with those
not at risk. For example, 97% of respondents recommended open heart surgery
for an infant with no known HIV risk but only 77% recommended surgery for
an infant whose mother had acquired immunodeficiency syndrome; if certain
the infant was infected, 42% of respondents recommended surgery. We
conclude that perceived HIV status may influence decision making about
treatment for non-HIV-related conditions for critically ill patients,
including infants not actually infected. Ethical issues concerning the
relevance of HIV status need to be examined.
