• J Wallner.
• Universität Wien, Institut für Ethik und Recht in der Medizin, Wien, Osterreich. juergen.wallner@univie.ac.at
• Z Geburtshilfe Neonatol. 2009 Aug 1; 213 (4): 147-54.

BackgroundMany decisions in neonatology are complex and demanding. Consequently, the involved persons can expect guidance which is provided to them by specialist organisations of the scientific community. Their documents deal with such substantial questions as how to treat extremely premature newborns and severely ill infants. They also address procedural aspects of the decision-making process; however, they could be made more transparent in this respect.ObjectiveThis paper aims to address those factors which may facilitate or hinder the neonatal decision-making process; regarding the legal framework, the countries Germany, Austria, and Switzerland are in the focus of this analysis. Thus, transparency, clarity, and predictability of the decision-making shall be enhanced.ResultsThe following components of the decision-making process will be addressed: decisional framework factors, decision makers, decision types, decision steps, and decision consequences. Emphasis is placed on a compact visualisation of the process in order to communicate it more easily to younger team members.ConclusionsGood decision making in neonatology must be context sensitive. General guidelines can be a helpful resource for carefully developing such a process. By taking the factors described in this paper into consideration, this task will be completed more efficiently.Georg Thieme Verlag KG Stuttgart.New York.

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