Wednesday, 19 August 2009

Neo-natal care

The specialist field of neonatology came into being to meet the needs of infants delivered in difficult midwifery situations. Low birth weight (premature) children - less than 3.5lbs - account for about 1% of births and survival for such children before specialist intervention occurred was bout 25%. this is now around 75%.

Malformed children account for about 1-2% of all births and, with the important exception of brain malformations, the prognosis for normal life for many of these children is fairly good as neonatal intensive care and surgery have improved. Many previously lethal malformations are treatable with good out6come if diagnosis is made early, and detection techniques are imporving so that early treatment is made possible.

Professional attitudes to this type of work are ambivalent. Some consider these infants as 'nature duds' and would not feel that any treatment was appropriate, especially in view of the high costs involved. 'Foetal medicine' - concerned maily with screening ofr abnormality and termination of pregnancy, if such abnormality is found - has been developing in parallel. In this context it is permissible both in Scots law, and more recently in English Law, to terminate a pregancy for reasions of severe foetal abnormality right up to term.

It has been observed that in deciding how much should be done in such cases of malformation and birth abnormality, a good deal of reliance may be placed on the intuitive responses of parents and others involved, since the general philosophy is still towards the concept of sanctity of life. This may pwe something to the general awareness of a Judaeo-Christian heritage and background.

In some areas of secular philosophy, however, opinions may differ markedly from this approach. Some would express the idea that a child is not yet fully a person, but only a potential person and therefore should have no rights until it has self-awareness. This view is reminiscent of the arguments about personhood in the abortion debate. It is striking that ethicists seem to differ quite markedly from the general public in these matters.

Additional Readings

It is not always possible to provide links to the full texts of related documents to the posting, however whenever possible, I am including links to the abstracts.

Sklansky, M. (2001). Noenatal Euthanasia: Moral Considerations and Criminal Liability. Journal of Medical Ethics.

Kon, AA. (2007). Neonatal Euthanasia is unsupportable: the Groningen protocol should be abandoned. Abstract available here.

Costeloe, K. (2007) Euthanasia in Neonatals. Abstract available here.

This link details to choice made by a mother concerning a screening during her pregnancy.


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