The ethics of prolonging life in fetuses and the newborn
Fri, 1 October 2004
The Nuffield Council on Bioethics today announced a new Working Party to consider issues surrounding the prolonging of life in fetuses and the newborn.
In recent decades there have been great improvements in the care of very premature and critically ill babies. Knowledge about pregnancy and the fetus has also increased, even allowing some treatment to take place while the fetus is still in the womb. We are able to sustain the life of even some extremely premature babies. However, it remains difficult to make accurate predictions for the quality of life that babies born at this very young age will be able to achieve. Some technological interventions have meant that the lives of critically ill babies can be prolonged when there is a small chance of recovery or survival in the longer term. In some children, premature delivery, congenital problems or complications at birth may result in disability, the extent of which is difficult to predict.
The Working Party will review the guidance on treatment for these babies and current practice in neonatal units. Members will also examine scientific advances and potential developments in this area of medicine. The focus of discussion will be the ethical, social, legal and economic issues involved in making very difficult decisions regarding treatment. The range of expertise within the Working Party will ensure that the roles of the family, medical professionals and the wider population will be considered.
“This Working Party will cover some very sensitive issues which have a great effect on people’s lives. We will be discussing not only how decisions are made, but also the longer term consequences of these decisions,” said Chair, Professor Margaret Brazier of the Manchester University School of Law. The Working Party will meet over the next 18 months, and will hold a series of fact-finding meetings. Members of the public, professionals and organisations will be invited to contribute to a public consultation, which will be conducted in the spring of 2005. The Council expects to publish a Report on its findings and recommendations in autumn 2006.
Notes to editors:
1. For further information please contact:
Elaine Snell, Public Relations Consultant, PO Box 10461, London SW11 6ZJ
Tel: + 44 (0)20 7738 0424, Mobile: +44 (0)7973 953 794
e-mail: elaine.snell@which.net
2. The Nuffield Council on Bioethics is an independent body which examines the ethical issues raised by developments in medicine and biology. Established in 1991, it is funded by The Nuffield Foundation, the Medical Research Council and The Wellcome Trust.
3. Membership of Working Party
Professor Margaret Brazier OBE (Chair)
Professor of Law, The University of Manchester
Professor David Archard
Professor of Philosophy & Public Policy, Institute of Environment, Philosophy & Public Policy, Furness College, University of Lancaster
Professor Alastair Campbell
Emeritus Professor of Ethics in Medicine, Centre for Ethics in Medicine, University of Bristol
Professor Linda Franck
Professor & Chair, Children’s Nursing Research Centre for Nursing and Allied Health Professions Research, Great Ormond Street Hospital
Ms Bonnie Green
Head of Professional and Public Affairs, BLISS
Professor Erica Haimes
Executive Director, Policy, Ethics & Life Sciences Research Institute Bioscience Centre, Newcastle upon Tyne
Dr Monica Konrad
Department of Social Anthropology, University of Cambridge
Professor Neil Marlow
Professor of Neonatal Medicine, School of Human Development, Queen’s Medical Centre, Nottingham
Professor Catherine Peckham (Deputy Chair of the Council)
Professor of Paediatric Epidemiology, Institute of Child Health, University College London
Dr Stavros Petrou
Health Economist, National Perinatal Epidemiology Unit (NPEU), University of Oxford
Professor Charles Rodeck
Head of Department, Department of Obstetrics and Gynaecology, University College London
Dr Philippa Russell CBE
Policy Adviser for Disability, National Children’s Bureau, London
Ms Anne Winyard
Partner, Leigh, Day & Company., Solicitors, London
Professor Andrew Whitelaw
Professor of Neonatal Medicine, University of Bristol Medical School, Bristol
4. 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 Wed, 15 December 2004