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Nuffield Cirriculum Centre

Critical care decisions in fetal and neonatal medicine: ethical issues

Terms of Reference

1 To identify and consider ethical, social, economic and legal issues arising from recent developments in fetal and neonatal medicine relating to prolonging life.


2 To examine scientific and medical research in these fields, considering in particular:

a. diagnostics;

b. fetal surgery;

c. neonatal care (including resuscitation);

d. recent evidence on the capacity of fetuses and the newborn to experience pain and suffering.


3 To examine current medical practices in these fields and their outcomes in the UK and more widely. In particular to review:

a. implications arising from the possibility of survival of premature babies of increasing frailty and at lower ages;

b. the relationship between changing survival rates and longer term outcomes.


4 To consider issues raised by advances in research and practice, particularly:

a. arguments about the moral and legal status of fetuses beyond the first trimester and the newborn;

b. the ethical and legal basis for providing, withdrawing or withholding life-prolonging treatment;

c. the process of decision-making, including the relative roles of families and healthcare professionals;

d. the availability of support for families in the short and the long term;

e. resource implications for providers of healthcare, education and social care.


5 In light of the above, to make recommendations.

Last Updated Thu, 8 December 2005

© NCOB 2004