Critical care decisions in fetal and neonatal medicine: ethical issues

Published 15/11/2006

This report discusses the ethical, legal and social issues raised and proposes guidelines on giving intensive care to babies born before 26 weeks.

To identify and consider ethical, social, economic and legal issues arising from recent developments in fetal and neonatal medicine relating to prolonging life.
To examine scientific and medical research in these fields, considering in particular:
1. diagnostics
2. fetal surgery
3. neonatal care (including resuscitation)
4. recent evidence on the capacity of fetuses and the newborn to experience pain and suffering
To examine current medical practices in these fields and their outcomes in the UK and more widely. In particular to review:
1. (a) implications arising from the possibility of survival of premature babies of increasing frailty and at lower ages
2. (b) the relationship between changing survival rates and longer term outcomes
To consider issues raised by advances in research and practice, particularly:
1. arguments about the moral and legal status of fetuses beyond the first trimester and the newborn
2. the ethical and legal basis for providing, withdrawing or withholding life-prolonging treatment
3. the process of decision-making, including the relative roles of families and healthcare professionals
4. the availability of support for families in the short and the long term
5. resource implications for providers of healthcare, education and social care
In light of the above, to make recommendations

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