Date of Award


Document Type


Degree Name

Master of Arts

First Advisor

John C. Fletcher

Second Advisor

Craig Eisendrath


This monograph addresses some of the specific problems related to counseling parents of defective newborns. It describes the experience of the writer over a five year period, 1972- 1977, in the neonatal unit of Goergetown University Hospital , Washington, D.C. During this period approximately two hundred fifty parents of defective newborns and may times that number of parent of children with lesser problems, utilized the hospital's services. My direct counseling experience was with thirty of these parents during the process of making the very difficult decisions about continuing support care for their critically ill infants.

At Georgetown I worked intimately with Dr. David Abramson, Chief of Neonatology. Over a period of three years, we formulated the method of working with parents described in this monograph. We also worked closely with Dr. Mary Kate Davitt, who became the Chief of Neonatology after Dr. Abramson left. Together Drs. Abramson, Davitt and myself conferred in great detail about what we were trying to do with parents and how best to accomplish it . Our clinical findings about what happens psychologically to parents of defective newborns , and what can be done to help them are very similar to the scientific findings of Klaus and Kennell (1977).

In 1975 Or . Abramson and I met with two ethicists who were interested in this decision making process, Richard McCormick, sj, and John C. Fletcher, Ph . D. These meetings stimulated our thinking and improved our work with parents . In addition I worked closely with staff, residents, students, doctors and nurses. I also taught counseling parents of defective newborns to medical students, learning much from these meetings. During these years I had the opportunity to speak with many other professionals both at Georgetown and at other hospitals such as Columbia Hospital for Women, (Washington , D. C.) , Fairfax Hospital (Virginia), Eastern Maine Medical Center (Bangor) and Grace New Haven Hospital (Connecticut), regarding this subject.

Interviews and case studies were my major research techniques. I interviewed five neonatologists, ten pediatricians, five residents, ten nurses and eight clergy . I interviewed five sets of parents and two mothers for their retrospective views of the process they had been through with their defective newborns.

I am grateful to all the parents who were willing to share their thoughts and feelings with me. I am grateful to all the professionals who related their thoughts on the issues of ethics, their feelings about illness, death and dying and their counseling of parents . I am particularly grateful to Dr. Raymond Duff for his help and support . I am also grateful to my special friends and colleagues , Susan Bradford, Catherine Bell and Patricia McHenry for their help and support in writing this paper . Dr . Georgia Fuller gave me support and help, particularly with the chapter on religion , for which I am grateful.

From these years of counseling, teaching, discussing and interviewing , I formulated ideas about what other professionals need to know about the counseling process. They are presented in this monograph for physicians, social workers, nurses, counselors, clergy, and students, and others in this field.

To summarize the dilemmas these professionals have faced, the psychological and social problems of parents of defective newborns have been stated in the literature but suggestions for solving their problems have not been forthcoming . Parents of defective newborns have a greater separation and divorce rate than the average couple. Parents a r e often depressed and angry with little or no way to get help with these feelings. Problems with the couples' intimate relationships and problems which include the siblings and extended family usually arise as well. Parents often go through a religious crisis which so far has not been discussed in the literature.

In addition, little has been written about the moral and psychological problems felt by the physicians and nurses who care for these infants and their parents . There is a large turnover of nurses in the neonatal unit because of the severe psychological and physical pressure. The average "life-span" (job span actually) of a neonatologist is only four to five years. This pressure relates to what I call the "humanization of the health care professional. " Doctors and nurses must be in touch with their own human, emotional reality before they can effectively help parents in emotional situations . Doctors and nurses must be in touch with their own feelings about the entire situation--infant , parents, ethics, religion and society--before they can most effectively help parents deal with their feelings about these issues . Doctors and nurses must be in touch with their own mortality and have dealt with at least some of their feelings about their own death . Current medical training does not address this "humanization'' problem. For example, several doctors admitted that they feared their own death and that was one reason they were in medicine.*

In this monograph I will share the ways we found to help parents suffering the crisis of a defective newborn . It is by no means meant as a rigid formula. Each hospital and staff are different and must make their own adaptations.

All parents' names are changed to protect their anonymity. The residents and nurses that I interviewed did not want their names used, therefore, are recognized only as resident or nurse.

C. Dilworth, ** a poet, philosopher and friend, who taught me much about living and dying , wrote these words shortly before his death:

... There is one week of silence over our village

... For some few it may be a private silence forever

... Two births do not take the place of one who passes through our village ... in the loneliness of dying .


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Creative Commons Attribution-NonCommercial 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

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