Preterm underweight neonates: An examination of the ethics of withdrawing and withholding treatment

Incidence of severe disability or early death in very pre-term or extremely low birth-weight babies is very high. Our technological ability to maintain life-signs in such neonates causes the severely disabled population to rise in relation to total births. Considerable pain and distress are involved in continuing life for some of these infants. Distress to parents and doctors, when the life of a neonate is ended, is also great. Additionally, it is a matter of great public concern. Do official Guidelines issued by Royal Colleges effectively tackle such heart-wrenching problems? Or are they a sugar-coating, allowing the medical profession to allay bitterness of public or parental reproach? Are such Guidelines effective in handling situations where there is little or no chance of satisfying many conflicting moral demands. Can they satisfy the dilemmas posed by an NHS under strain? Only a process of ongoing, constructive criticism can reassure us that we are doing everything humanly possible for the plight of these unfortunate infants – as well as for those intimately involved in their so often tragically short lives. The aim of this volume is hopefully to go some way in filling a gap. It is particularly timely in that the official Guidelines are due for further review . . .