After the infant’s birth, the neonatologist’s first duty is to his or her patient—the newly born infant. If clinical circumstances are different than anticipated, the physician must first consider the best interests of the baby.
The greatest pressure to resuscitate the extremely low-birth-weight infant often results from successful marketing efforts that lead families to expect that their premature infants will be cute and healthy.
Hydration at the end of life may be much less beneficial than generally assumed, but the emotional significance of nourishment to caregiving should not be underestimated.
Frank A. Chervenak, MD and Laurence B. McCullough, PhD
Clinical facts and physicians’ ethical obligations are critical in resolving disagreements between parents and physicians about resuscitation of an extremely premature infant.
Nonlegal, judicial, and statutory courses of action are available to patient surrogates and physicians who cannot agree on withdrawal of life-sustaining treatment.
Guidelines exist for delivery-room treatment for newborns at the margins of viability, and when the rules and limits are reached, parental values are important.
Guidelines exist for delivery-room treatment for newborns at the margins of viability, and when the rules and limits are reached, parental values are important.
When evaluating the developments and complications of a marginally viable premature infant, physicians and parents must work together to decide on treatment that is in the infant’s best interest.
Physicians should fully understand the ethical principles and professional standards involved in making decisions for the treatment of impaired newborns.