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.
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.
Physicians should fully understand the ethical principles and professional standards involved in making decisions for the treatment of impaired newborns.
Nonlegal, judicial, and statutory courses of action are available to patient surrogates and physicians who cannot agree on withdrawal of life-sustaining treatment.
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 are obligated in many jurisdictions to perform life-sustaining treatments on premature infants with serious developmental or physical impairments, even if it goes against the parents' wishes.
Physicians need to carefully explain the difficult medical realities of carrying a fetus with severe congenital abnormalities to term but then follow the wishes of a religious family who ask for reasonable medical care.