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Cases illustrating variables relevant to the decisions of pregnant women about methods of childbirth, elective cesarean delivery, impaired newborns, and sex assignment at birth are presented. For each topic, empirical and theoretical factors relevant to the cases are discussed from an “egalitarian perspective” that imputes privileged status to the standpoint of those who are “nondominant”. Implications of different positions about moral status of fetuses and newborns are also considered.

This chapter examines the meta-ethical question regarding subject selection in newborn screening for diabetes. Data show that over 90% of parents give permission for diabetes screening of their newborns in the US and abroad. It is argued that prediction research in newborns has potentially serious psychosocial implications, especially when it is introduced into the unsuspecting general population, and research designs must account for them. Recommendations are proposed that balance the need for research access with protection, to minimize harm to infants and their families.

This chapter focuses on two developments that will speed up change in the population profile of DHH children: early identification through universal newborn hearing screening (UNHS) and early cochlear implantation. Studies show that children identified through UNHS within the first weeks of life have superior development on a wide range of measures, both linguistic and social-emotional, compared with children whose hearing loss was identified at later ages. The literature also provides compelling evidence of an improved rate and level of spoken language development for most children with severe to profound sensory-neural deafness who receive a cochlear implant, provided that they receive consistent input in spoken language. The chapter argues for an alternative approach to early intervention, which seeks to identify — at the earliest possible stage — those children for whom spoken communication may not be entirely accessible and for whom signed communication will likely be necessary to ensure their linguistic, social, cognitive, and emotional development. It then seeks to provide those children with a program focusing on the development of both spoken and signed language (or communication).

This chapter outlines key methodological issues in collecting and analyzing data on outcomes in individuals with genetic disorders that are candidates for inclusion in screening panels, and reviews the relevant literature for two disorders that have relatively abundant evidence. One disorder is medium-chain acyl-CoA dehydrogenase deficiency (MCADD), which is a fatty acid oxidation disorder that is the most common of the new disorders detected by mass-throughput MS/MS technology. MCADD has been the “poster child” for expanded newborn screening. The other disorder is cystic fibrosis (CF), which is also increasingly being added to screening panels.

This chapter presents lessons that can be learned from the four regimes of assisted death examined in this study. The number of individuals who have sought aid in dying has been relatively small and for the most part has been limited to cases of intractable suffering in terminal illness. As knowledge of this remedy spreads, the idea of assisted death becomes more acceptable to both doctors and the public and the number of cases increases. Hence, the number has ranged from 0.19% of all deaths in Oregon to 2.2% in the Netherlands. Contrary to earlier concerns, the enactment of legislation allowing assisted death has everywhere given to a boost to palliative care. Assisted death thus has functioned not as an alternative to the best end-of-life care available, but as a way out for those who suffer inordinately despite all efforts to palliate. The scope of these laws varies. The three European regimes require merely the presence of lasting and unbearable suffering, while Oregon insists that patients be in the terminal phase of their illness. The chapter examines the downside of each approach. It also presents a model statute for the regulation of physician-assisted suicide prepared by specialists in the fields of law and medicine. It concludes that the prolonged experience with assisted death in the four national entities examined makes it possible to develop a regime that will satisfy the need for dignity in dying, assure accountability, and provide adequate safeguards against abuse.

Newborns are largely naïve when they enter the world. How can they make sense of the wealth of stable or moving objects, events, and people that they encounter through audition, vision, touch and olfaction? This chapter focuses on the various perceptual mechanisms and crossmodal interactions that exist in newborns. Some crossmodal interactions, such as chemosensory interactions, stem from the prenatal life of the newborn; while others, such as auditory-visual and tactile-visual interactions, only emerge at birth. These interactions present different complexities and levels of processing. Crossmodal interactions observed in human newborns involving the chemical senses, audition, and vision are discussed first. Then, the relations between the visual and the tactile modalities in newborns are examined in detail. These relations shed light on an old philosophical question: Molyneux’s famous question (July, 7, 1688) and the origin of crossmodal identity.

Synaesthesia is a neurological phenomenon that often involves crossmodal or cross-dimensional perceptions which are not related to environmental stimuli. Stimulation of one sense, such as hearing, triggers the normal perception of a specific sound, but also an additional perception, often in another sense, such as a specific colour. This chapter summarizes the evidence suggesting that synaesthesia is a remnant of a normal developmental process involving an initial proliferation of synaptic connections, including connections linking cortical areas that will later become specialized for unisensory processing. An argument is put forward that crossmodal and cross-dimensional associations commonly manifested in synaesthetic adults provide clues about cortical connections in early childhood that may influence perception in the typical non-synaesthetic child. Behavioural evidence from children is provided to support this point of view. This chapter also argues that remnants of the original connections are present even in non-synaesthetic adults, in whom their influence is manifested not in conscious perception, but in implicit crossmodal associations in perception.

This chapter studies various aspects of family fertility in Taiwan and China, including the age of marriage, the duration from marriage to the first birth, mandatory vs. voluntary family planning, the contraceptive practices, the preferences for sons, the newborn sex ratio, and the quantity‐quality tradeoffs. With respect to basic statistics, various measures against the degree of urbanization and the educational level of wives are cross‐tabulated. Concerning quantity‐quality tradeoffs, the instrumental variable method was applied and it was found that there does not exist a negative relationship between sibship size and educational attainment, for both Taiwan and China. Finally, the analysis on birth duration shows that co‐residing with the husband's parents shortens the first two birth durations in Taiwan.

Screening for metabolic, endocrine, and other diseases in newborns is performed through the laboratory analysis of dried blood spot specimens. This chapter reviews economic evaluations of newborn dried blood spot screening strategies published during 2002-07, focusing on the cost-effectiveness of screening for cystic fibrosis, congenital adrenal hyperplasia, and medium chain acyl-CoA dehydrogenase deficiency (MCADD). The use of tandem mass spectrometry (MS/MS) to detect MCADD is presented in detail, through examinations of the costs of screening and medical management, and of outcomes, including quality-adjusted life year (QALY) measurement, disability, and mortality. Ways to generate higher quality evidence are presented. The chapter concludes with a discussion of the use of economic evaluations to inform newborn screening policies.

This chapter examines the experience of the mother and her child immediately following birth in Tudor and Stuart England. The midwife was responsible for checking the health condition of the newborn infant and in cutting the umbilical cord. The child's navel, especially those of the first born, was traditionally inspected by childbed assistants to predict the mother's future childbearing. The babies were often wrapped tightly in linen bands before being laid in a cradle. The responsibility of providing refreshment and ointment to the new mother was taken by those other childbed assistants including a nurse, relatives, or neighbours.

The chapter considers the ownership of newborn screening cards (also known as Guthrie cards) and the blood spots retained on them, the role of consent to the use of these cards and relevant data protection provisions which have resulted in challenges to their retention. The issues raised here also have relevance for biobanks and other existing archives of retained biological samples in hospitals and research facilities as similar questions arise in relation to those collections. The chapter recommends that legislation be introduced to exempt the newborn screening card collection from data protection legislation and to put in place a clear and robust governance framework to ensure that individual rights are protected to the greatest extent possible. These recommendations are also relevant to other collections of biological samples in which a strong argument exists for their retention for diagnostic purposes as well as for public health

This chapter explores the possibilities for the music therapist employing infant-directed singing both with the infant's family, and also directly with the infant. First, the experience of the healthy infant in the context of the infant's family is presented, and then an exploration of the hospital experience for a newborn infant and family creates a picture about the potential and value of music therapy in this context. Finally, the chapter focuses on how and why infant-directed singing provides a simple yet potent experience for the developing infant.

This chapter gives an understanding of the essential tasks involved in setting up a good quality screening programme. Newborn hearing screening is used as a case study. There is an old saying that all you have to do to create an effective service is choose the right things to do, then do them right. Choosing the right screening involves assessing the evidence and making policy. Doing screening right means setting up a well ordered programme when screening is worthwhile, ensuring that the service is always of high quality, dealing effectively with problems, and making sure that when harm is more likely than benefit then screening does not happen. The chapter focuses on matters that are essential if screening is to achieve public health improvement — irrespective of where, and in what type of health system, it is being delivered.