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Physicians' Refusal to Resuscitate at Borderline Gestational Age

Journal of Perinatology volume 25, pages 685–689 (2005)Cite this article

Abstract

Most neonatologists believe there is a minimal gestational age, below which it is appropriate to refuse to provide resuscitation or intensive care. Determination of this threshold should involve knowledge of the outcome data, but also an understanding of the potential for misuse of these data. In particular, there is a risk of deception, of the parents and of ourselves, due to the uncertainty of the true gestational age, and the “self-fulfilling prophecy” that may occur when a center refuses to try below a certain gestational age because they have had no survivors below that age. Finally, any refusal to treat requires ethical justification. Concepts such as futility and patient's best interest should play a role in the determination of the gestational age threshold, applied in light of the data's inherent weaknesses.

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Acknowledgements

The author is grateful to Steven Peterec MD for helpful comments and suggestions.

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  1. Department of Pediatrics (M.R.M.), Yale University School of Medicine, New Haven, CT, USA

    Mark R Mercurio MD

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  1. Mark R Mercurio MD
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Mercurio, M. Physicians' Refusal to Resuscitate at Borderline Gestational Age. J Perinatol 25, 685–689 (2005). https://doi.org/10.1038/sj.jp.7211395

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