| In the fast-paced environment of the neonatal intensive care unit (NICU), decisions about the health care of newborns involve multiple—and sometimes competing—normative forces. Informed by critical legal pluralism, this thesis offers an analysis of the normative interactions that emerge when parents and health care professionals meet at the bedside of a critically ill newborn. Using the shared decision-making model favored by the Canadian Paediatric Society (CPS) in its 2004 position statement on treatment decisions regarding infant, children and adolescents, I claim that in the NICU context consent is not sought in cases of medical certainty, where the best interest of the patient has already been ascertained according to medical norms. Consequently, the “shared” component of decision-making occurs only after the cause for decision-making has been determined by the child's health care team and presented to the child's surrogate decision-makers. Using ethnographic studies on the lived experience of parents in NICU, I question the marked difference between the authority given to parents by Canadian legal and medical guidelines and the authority they are allowed to exercise in fact at their child's bedside. I conclude by a critical reflection on the emergence of plural law in the NICU trough dynamics of parental resistance or conformity to accepted medical norms. |
