title: Approaches to ethical decision making in the neonatal intensive care unit.
abstract: Despite the "Baby Doe" regulations, there is no consensus on principles for deciding the fate of severely handicapped neonates. This essay analyzes four alternate positions--value of life, parental authority, best interests, and personhood--and suggests for consideration a fifth, ie, proximate personhood. The latter position, building on the strengths of the first four, argues that a handicapped newborn must possess a reasonable potential for minimal personal capacities to have a unique claim to life. Projected minimal capacities include personal self-awareness and net physiological benefit. If newborns are not expected to develop such capacities, parents should be free to choose the option of nontreatment.
authors.affiliation: Christian Ethics Department, Loma Linda, Calif., University, School of Religion.
authors.forename: J W
authors.initials: JW
authors.lastname: Walters
mesh_terms: D000015:Abnormalities, Multiple / Q000628:therapy; D018864:Cultural Diversity; D003659:Decision Making, Organizational; D004989:Ethics; D004991:Ethics, Institutional; D005066:Euthanasia, Passive; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D010290:Parents; D010344:Patient Advocacy; D018579:Patient Selection; D028723:Personhood; D011788:Quality of Life; D040841:Resource Allocation; D018570:Risk Assessment; D012945:Social Values; D026712:Value of Life; D035761:Wedge Argument; D028761:Withholding Treatment