ENFERMAGEM NEONATAL EM CUIDADOS PALIATIVOS: DILEMAS ÉTICOS PARA UMA ASSISTÊNCIA INTEGRAL
Bibliographic record
Abstract
Introdução: Os avanços na neonatologia permitiram a sobrevivência de bebês em limites de viabilidade, porém enfrentam dilemas éticos devido à prematuridade e suas consequências a longo prazo, destacando a importância da decisão compartilhada com os pais. No Brasil, desafios como extensão territorial e desigualdades impactam os cuidados paliativos neonatais, enquanto estudos internacionais, do Japão, Itália, Coreia do Sul, Canadá e Estados Unidos, revelam problemas comuns na implementação desses cuidados, refletindo uma dificuldade global em abordar a morte e o morrer em neonatologia, ressaltando a necessidade de melhorar a assistência e enfrentar os dilemas éticos envolvidos. O avanço tecnológico permitiu diagnósticos precoces e aumentou a sobrevida de bebês prematuros com doenças crônicas. Paralelamente, a competência e formação dos enfermeiros em cuidados paliativos neonatais são cruciais, enfrentando desafios de conhecimento, práticas, e colaboração interprofissional, evidenciando a necessidade de uma abordagem mais integrada e humanizada no cuidado aos bebês e apoio às famílias em luto. Deste modo foi concebida uma tabela catalogando os principais dilemas éticos identificados na revisão bibliográfica. Conclusão: O estudo reitera a complexidade dos dilemas éticos enfrentados pelos profissionais de saúde em neonatologia e a essencialidade de uma formação profunda em cuidados paliativos, visando sempre a tomada de decisões éticas, informadas e centradas no paciente e sua família. Introduction: Advances in neonatology have allowed the survival of babies at the limits of viability, but they face ethical dilemmas due to prematurity and its long-term consequences, highlighting the importance of shared decision-making with parents. In Brazil, challenges such as territorial extension and inequalities impact neonatal palliative care. At the same time, international studies from Japan, Italy, South Korea, Canada, and the United States reveal common problems in implementing this care, reflecting a global difficulty in addressing death and dying in neonatology, highlighting the need to improve care and face the ethical dilemmas involved. Technological advances have allowed early diagnoses and increased the survival of premature babies with chronic diseases. At the same time, the competence and training of nurses in neonatal palliative care are crucial, facing challenges in knowledge, practices, and interprofessional collaboration, highlighting the need for a more integrated and humanized approach to caring for babies and supporting families in mourning. In this way, a table cataloged the main ethical dilemmas identified in the literature review. Conclusion: The study reiterates the complexity of the moral dilemmas faced by health professionals in neonatology and the essentiality of in-depth training in palliative care, always aiming to make ethical, informed, and patient- and family-centered decisions.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.001 | 0.004 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.010 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".