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Medical Ethics on the Year of Neonatal Jaundice Campaign

1539

Sukhit Phaosavasdi MD*,
Boonchai Uerpairojkit MD*, Manopchai Thamkhantho MD, MRCOG*,
Chumsak Prugsapong MD*, Aurchart Karnjanapitak MD*

* Member of Thai Medical Association

Abstract


For the last decades, the severity of neonatal jaundice had been dramatically rising, not only cause of neonatal death, but also million of dollars to be paid by doctor who has being sued or claimed. It can be clearly seen in Thai medical society nowadays(1).
It is very threatened to realize that even only minimal amount of bilirubin can totally damage vital organs. According to the medical knowledge and medical journal, it has been widely mentioned about the critical level of bilirubin, the plan of treatment and the severity of diseases(2-5).
At present, the international medical journal, helping us to understand more about neonatal jaundice particularly the surveillance and screening of the hyperbilirubinemia in newborn. Unfortunately it is still unpredictable to the outcome of treatment of before or after hyperbilirubinemia in vital organs(6-8).
In summary of neonatal jaundice
1. The facts of hyperbilirubinemia in newborn.
1.1 The pathological autopsy can prove the condition of hyperbilirubinemia in vital organs.
1.2 Even the level of bilirubin only 4.4% can cause kernicterus condition.
1.3 No evidence-based of study to show the critical level of bilirubinemia can damage the vital organs or even death.
1.4 Hyperbilirubinemia in vital organs such as brain, lung, liver and GI tract can be either symptomatic or asymptomatic and also death or chronic illness.
1.5 Phototherapy can reduce the level of hyperbilirubinemia.
1.6 Phototherapy, not for the treatment of complications in vital organs.
1.7 Blood exchange is the treatment of choice for hyperbilirubinemia.
1.8 Blood exchange, is not for the treatment of complications in vital organs.
1.9 Blood exchange, can be cause of death or even fatal complications.
1.10 There are some misunderstandings regarding the reduction of the level of bilirubin to cure the complication of the diseases.
2. The facts of “KERNICTERUS” condition.
2.1 The hyperbilirubinemia in brian can cause this fatal condition, and also be confirmed from the autopsy.
2.2 It is one of fatal condition which occur in hyperbilirubinemia of the newborn.
2.3 It can effect the central nervous system, i.e. delay the growth and development of the newborn, defect the brain-controlled function such as deafness, blindness, limbs atrophy, joints demobility, spasticty of muscles.
2.4 It has been contradicted that even the sky high level of hyperbilirubinemia.
2.5 No damage of phototherapy on central nervous system or neonatal death.
2.6 Blood exchange for neonatal jaundice can cause the fatal complications or even death.
Accordingly, the above issue, the Journal of the Medical Association of Thailand has campaigned year 2004 and 2005 as the year of neonatal jaundice, so the original articles, review articles, case reports regard-ing to neonatal jaundice are all welcome for publication in Journal of the Medical Association of Thailand.

Keyword : Neonates, Jaundice



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