title: Are newborns morally different from older children?
abstract: Policies and position statements regarding decision-making for extremely premature babies exist in many countries and are often directive, focusing on parental choice and expected outcomes. These recommendations often state survival and handicap as reasons for optional intervention. The fact that such outcome statistics would not justify such approaches in other populations suggests that some other powerful factors are at work. The value of neonatal intensive care has been scrutinized far more than intensive care for older patients and suggests that neonatal care is held to a higher standard of justification. The relative value placed on the life of newborns, in particular the preterm, is less than expected by any objective medical data or any prevailing moral frameworks about the value of individual lives. Why do we feel less obligated to treat the premature baby? Do we put newborns in a special and lesser moral category? We explore this question from a legal and ethical perspective and offer several hypotheses pertaining to personhood, reproductive choices, "precious children," and probable evolutionary and anthropological factors.
authors.affiliation: McGill University, Montreal, Quebec, Canada. annie.janvier@muhc.mcgill.ca
authors.forename: Annie
authors.initials: A
authors.lastname: Janvier
authors.forename: Karen Lynn
authors.initials: KL
authors.lastname: Bauer
authors.forename: John D
authors.initials: JD
authors.lastname: Lantos
mesh_terms: D003643:Death; D003657:Decision Making / Q000941:ethics*; D026689:Ethical Analysis; D026690:Ethics, Clinical; D005195:Family Relations; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal / Q000941:ethics* / Q000331:legislation & jurisprudence; D028681:Moral Obligations; D009359:Neonatology / Q000941:ethics*; D011788:Quality of Life; D016896:Treatment Outcome; D035501:Uncertainty; D026712:Value of Life; D028761:Withholding Treatment / Q000941:ethics* / Q000331:legislation & jurisprudence