Ethical considerations of aggressive care of very low birth weight infants

The issues surrounding aggressive treatment of at-risk infants have tended to be reduced to superficial dichotomies such as parent versus infant rights and sanctity versus quality of life. Public debate has typically been restricted to isolated aspects of extreme individual cases. By routinizing decisions and minimizing use of research protocols in the care of VLBW infants, health care professionals have made issues related to aggressive care appear less consequential than they are. This process, combined with limited access by significant sectors of society, has severely curtailed effective debate about a highly complex and important problem. Nurses have a responsibility to help establish an arena for this debate--in both individual cases and the formulation of public policy--and to facilitate participation by those whose input has been restricted.