Evidence-based ethics and the care of premature infants.
Despite the success of newborn intensive care, a vexing ethical question remains: Which preterm infants are so malformed, sick or immature that newborn intensive care should not be administered? In an attempt to answer this question, this article examines current clinical practices and the persisting effects of the controversial Baby Doe regulations. The scientific evidence for current practices is critically analyzed in relation to fundamental ethical issues for marginally viable patients of any age. A variety of strategies--some highly provocative--is proposed and discussed to facilitate better-informed, better-justified, more broadly acceptable, and more fiscally responsible ethical decisions in the care of preterm infants.
Tyson
J
J
University of Texas Southwestern Medical Center at Dallas, USA.
D006233:Persons with Disabilities / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D028741:Ethics Committees, Clinical; D004992:Ethics, Medical; D005066:Euthanasia, Passive / Q000331:legislation & jurisprudence*; D035082:Federal Government; D005260:Female; D005317:Fetal Growth Retardation / Q000401:mortality / Q000628:therapy*; D033161:Government Regulation; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000401:mortality / Q000628:therapy*; D007363:Intensive Care Units, Neonatal / Q000331:legislation & jurisprudence; D038622:Internationality; D008020:Life Support Care / Q000331:legislation & jurisprudence*; D018447:Medical Futility; D033282:Parental Consent; D018579:Patient Selection; D011247:Pregnancy; D035842:Research Subjects; D040841:Resource Allocation; D018570:Risk Assessment; D036302:Therapeutic Human Experimentation; D016896:Treatment Outcome; D035501:Uncertainty; D014481:United States / Q000453:epidemiology; D028761:Withholding Treatment