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Published on: February 16, 2011

Ethical dimensions of periviability

Daniel W Skupski1, Frank A Chervenak, Laurence B McCullough

  • 1Department of Obstetrics and Gynecology, Weill Cornell Medical Center, New York, NY 10021, USA. dwskupsk@med.cornell.edu

Journal of Perinatal Medicine
|September 3, 2010
PubMed

Insights

Caring for neonates born at the limits of viability presents complex ethical challenges. This statement outlines ethical principles and expert opinions for managing periviable pregnancies and neonates globally.

Area of Science:

  • Perinatal Medicine
  • Neonatal Care
  • Bioethics

Background:

  • Periviable births present significant medical and ethical challenges for healthcare providers.
  • The care of these high-risk pregnancies and neonates is complex and often involves ethical controversies.
  • Global disparities exist in managing periviable infants.

Purpose of the Study:

  • To summarize the ethical principles guiding the care of periviable pregnancies and neonates.
  • To provide expert clinical opinion on the challenges associated with periviable infant care worldwide.
  • To address key ethical considerations in the management of periviable infants.

Main Methods:

  • Review of published literature on periviable birth outcomes and ethical considerations.
  • Development of an ethical framework for decision-making.
  • Synthesis of expert clinical opinion on management strategies.
  • Analysis of specific clinical scenarios including neonatal resuscitation and limits of life-sustaining treatment.

Main Results:

  • Established an ethical framework for periviable infant care.
  • Highlighted the importance of translating neonatal outcome data for obstetric decision-making.
  • Discussed the role of management as a trial of intervention.
  • Addressed controversies surrounding cesarean delivery for fetal indications and limits on neonatal treatment.

Conclusions:

  • Care for periviable neonates requires a robust ethical framework and expert clinical guidance.
  • Translating neonatal data into obstetric practice is crucial for informed decision-making.
  • Ethical guidelines are essential for managing complex cases, including resuscitation and treatment limitations.

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