Should we resuscitate? Ethical dilemmas

Over a 2-year period, there were 312 perinatal deaths. A total of 144 (46.2%) of these deaths were due to lack of or delayed resuscitation at birth. This group comprised 45 infants with multiple congenital abnormalities, 31 with severe birth asphyxia, 25 with meningomyelocele, 20 with infections and 15 with kernicterus. Taking the decision not to resuscitate may be difficult, perplexing and agonizing for the families and health professionals. The decision may be easier if one can prognosticate as to intact survival and development. The physician, though he is not God, has to be firm and decisive--if intact survival or satisfactory developmental outcome is very unlikely, then ther is probably no need to resuscitate.