High and consistent ethical standards are crucial to modern clinical medicine and research. In fast-paced research and clinical landscapes, it is of particular importance that medical professionals regularly review and adjust their methods to align with fundamental ethical principles.

Ethical dilemmas are a daily occurrence in neonatal intensive care units. Neonatal clinicians are frequently confronted with them and are forced to reflect ethically. Neonatal multidisciplinary teams and parents (surrogate decision-makers) should engage in shared decision-making. This complex process, which can start prenatally, searches for the newborn’s best interest standard. In the course of this, it is essential to listen attentively and respectfully to others and to integrate their opinions, accounting for the complexity and individuality of every family and its values.

This Research Topic aims to explore in more depth the different ethical dilemmas that surround neonates and their families as well as the professionals who care for them. Many of these issues are centered on deciding, in a context of uncertainty, about the appropriateness of the establishment or withdrawal of therapeutic measures, in cases in which life expectancy and/or quality of life may be compromised, such as newborns in the threshold of viability or those with life-limiting illnesses.
From this central core arise other ethical issues such as neonatal palliative and hospice care, organ donation in NICU, the moral stress of professionals faced with these dilemmas, or the ethics of clinical research in this particularly vulnerable patient population unable to consent. These issues will be approached from different perspectives: health, socio-cultural, psychological, deontological, legal, and especially bioethical, with special consideration to issues such as consent, confidentiality, therapeutic futility, and quality of life.

Bioethics in Neonatology is led by a team of expert editors and aims to capture the latest high-quality literature on ethical practice, policy, and debate within neonatology. Impactful case studies and series will also be considered where they relate to specific, controversial, or new aspects in the field.

Sub-themes include, but are not limited to:
• Surrogate consent process and child’s best interests
• The value of the multidisciplinary team and the role of nursing
• Active listening and multicultural approaches
• Decisions in the threshold of prematurity
• Ethical dilemmas concerning neonates with life-limiting conditions and genetic diseases
• Prenatal ethical challenges and perinatal hospice care
• Discontinuation of life support and organ donation
• Moral stress in professionals

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Frontiers in Pediatrics

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