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.