An Extremely Premature Infant Between Life and Death. The Limits of Medical Intervention.

Abstract

Neonatology is a relatively young area of medicine, and one that has seen remarkable progress over the last decade in the available technology and therapy. There has been a major increase in the survival of the most immature newborns, as small as 500 g. A sobering reflection soon followed, with the first research showing increased risk of disrupted psychological and motor development among these children. The facts posed a new challenge to doctors, forcing them to face a number of pressing moral and ethical issues: Is supporting life in recognition of its sanctity or simply because it is technically possible, always justified? Once therapy has commenced, is it always to be continued? The author of this paper attempts to give an answer to these questions, from the perspective of a neonatologist with long professional experience. In her discussion of cases of newborns on the edge of viability she points to the limits of medical intervention and their sources. In the end she presents the steps towards final decisions, including practical reflections on how they can be taken.