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Semin Fetal Neonatal Med. 2014 Oct;19(5):290-5. doi: 10.1016/j.siny.2014.08.001. Epub 2014 Aug 19.

Infants of borderline viability: the ethics of delivery room care.

Author information

1
Children's Mercy Hospital and Clinics, 2401 Gillham Road, Kansas City, MO 64108, USA.
2
Children's Mercy Hospital and Clinics, 2401 Gillham Road, Kansas City, MO 64108, USA. Electronic address: jlantos@cmh.edu.

Abstract

For more than half a century neonatologists and ethicists alike have struggled with ethical dilemmas surrounding infants born at the limits of viability. Both doctors and parents face difficult decisions. Do we try to save these babies, knowing that such efforts are likely to be unsuccessful? Or do we provide only comfort care, knowing that, in doing so, you will inevitably allow some babies to die who might have been saved? In this paper, we review the outcome data on these babies and offer ten suggestions for doctors: (1) accept that there is a 'gray zone' during which decisions are not black and white; (2) do not place too much emphasis on gestational age; (3) dying is generally not in an infant's best interest; (4) impairment does not necessarily equal poor quality of life; (5) just because the train has left the station doesn't mean you can't get off; (6) respect powerful emotions; (7) be aware of the self-fulfilling prophecies; (8) time lag likely skews all outcome data; (9) statistics can be both confused and confusing; (10) never abandon parents.

KEYWORDS:

Best interests; Ethics; Guidelines; Premature; Resuscitation

PMID:
25153263
DOI:
10.1016/j.siny.2014.08.001
[Indexed for MEDLINE]

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