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Treatment Decisions for Newborns at the Threshold of Viability: An Ethical Dilemma

Journal of Perinatology volume 20, pages 379–383 (2000)Cite this article

Abstract

The major ethical issues involved in decision-making in the care of extremely low birth weight newborns are analyzed here. We propose a schema for assessment and management of these infants that is consistent with ethical principles broadly accepted by the pediatric community, and which takes into account mortality risk at any given institution rather than arbitrary weight limits, with a major decision-making role for the infant’s parents. When possible, the decision of whether or not to resuscitate should be made before delivery; when not possible, delivery room resuscitation is recommended, and the decision to continue or withdraw care should be made subsequently based on likelihood of survival and the wishes of the parents.

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Author information

Authors and Affiliations

  1. Department of Pediatrics (R. W. D.), Harbor-University of California Los Angeles Medical Center, Torrance, CA

    Robin W Doroshow MD

  2. Department of Pediatrics (J. E. H.), Los Angeles County-University of Southern California Medical Center, Los Angeles, CA

    Joan E Hodgman MD

  3. Department of Pediatrics (J. J. P.), Cedars-Sinai Medical Center, Los Angeles, CA

    Jeffrey J Pomerance MD

  4. Center for Healthcare Ethics (J. W. R.), Orange, CA

    Judith W Ross MA

  5. University of Southern California Law Center (V. J. M.), Los Angeles, CA

    Vicki J Michel JD

  6. Department of Pediatrics (P. M. L.), University of Texas, Southwestern Medical Center, Dallas, TX

    Peter M Luckett MD

  7. Department of Surgery, Olive View Medical Center, Sylmar, CA

    Anthony Shaw MD

Authors
  1. Robin W Doroshow MD
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  2. Joan E Hodgman MD
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  3. Jeffrey J Pomerance MD
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  4. Judith W Ross MA
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  5. Vicki J Michel JD
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  6. Peter M Luckett MD
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  7. Anthony Shaw MD
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Additional information

This work was supported by Chapter 2, District IX, American Academy of Pediatrics.

The deliberations on which this paper is based were conducted by the authors as members of the Committee on Bioethics of Chapter 2, District IX of the American Academy of Pediatrics. The recommendations contained herein do not represent those of the American Academy of Pediatrics.

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Doroshow, R., Hodgman, J., Pomerance, J. et al. Treatment Decisions for Newborns at the Threshold of Viability: An Ethical Dilemma. J Perinatol 20, 379–383 (2000). https://doi.org/10.1038/sj.jp.7200010

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  • DOI: https://doi.org/10.1038/sj.jp.7200010

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