Bioethics Blogs

Considering best care for extremely premature babies

A couple of weeks ago I was invited to attend a lecture given by Dr. Mark Mercurio of Yale University on making ethical decisions regarding the treatment of neonatal babies. Dr. Mercurio’s talk focused on the topic of aggressive treatment of extremely premature infants (22 – 25 week gestational age). Although I have devoted much of my time to researching beginning of life issues (predominantly issues focusing on the baby in-utero and the mother), I have only recently started focusing my attention more on ethical issues regarding neonatal topics. Dr. Mercurio’s presentation was extremely thoughtful and brought up some interesting and practical points for consideration; I thought I would share three that stood out to me with all of you this week.

1. Whether treatment is impermissible, permissible, or obligatory should be determined by two factors: prognosis and feasibility.

I appreciated this point because it recognizes that treatment needs to be both appropriate and actually possible. It is important to remember that the baby is the patient, and what is done in the form of treatment should be just that: treatment. Experimentation should not be presented as treatment if it is not known to actually provide treatment to the patient. While there is a time and place for developing experimental treatments, this must be presented as experimental and monitored closely to avoid any unethical conduct, any illegal conduct, or any harm to the patient.

2. Gestational age should not be the only factor used to decide whether or not to treat a premature infant.

Although gestational age seems like a decisive line to use to determine treatment, it is not the best indicator of how a baby will respond.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.