title: Parental rights at the birth of a near-viable infant: conflicting perspectives.
abstract: OBJECTIVE
  Our purpose was to clarify the roles of parents and caregivers in making decisions for resuscitation of near-viable infants.
  
  
  METHODS
  We present two cases and review ethical and legal issues involved in making decisions for near-viable infants.
  
  
  RESULTS
  Medical responsibility for the infant shifts at birth from obstetrics to neonatology. Neonatologists will "opt for life" when prognosis is uncertain. As surrogate decision makers, parents have rights to make decisions about initiation of resuscitation, but these parental rights are limited by the infant's best interests. If caregivers believe parents are not acting in the infant's best interests, they may persuade parents, challenge parental refusal by petitioning the courts, or treat without consent with possible legal risk.
  
  
  CONCLUSIONS
  Effective communication is essential to prevent misunderstanding and conflicts. In most instances parents are the best decision makers for a near-viable infant. Parental rights are limited by best interests of the infant.
authors.affiliation: Department of Obstetrics and Gynecology, University of Virginia School of Medicine, Charlottesville, USA.
authors.forename: J V
authors.initials: JV
authors.lastname: Pinkerton
authors.forename: J J
authors.initials: JJ
authors.lastname: Finnerty
authors.forename: P A
authors.initials: PA
authors.lastname: Lombardo
authors.forename: M V
authors.initials: MV
authors.lastname: Rorty
authors.forename: H
authors.initials: H
authors.lastname: Chapple
authors.forename: R J
authors.initials: RJ
authors.lastname: Boyle
mesh_terms: D004992:Ethics, Medical; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D010290:Parents; D010344:Patient Advocacy; D011247:Pregnancy; D011379:Prognosis; D012151:Resuscitation; D016414:Resuscitation Orders / Q000331:legislation & jurisprudence