Medico-legal and ethical issues in neonatology

Very small and sick neonates are being saved with modern technology. However, the cost is high. Obstetricians and neonatologists are often faced with the difficult task of deciding who is to be saved and who is not. In the USA, virtually all infants with any chance of survival are aggressively treated and stabilized until the future outcome can be certain. In addition, Infant Bioethical Review Committees are formed. In the UK such committees do not exist. Decisions are made by doctors together with parents. The practice in Australia is similar to that in the UK. It is recommended for Singapore that decisions should be made jointly by doctors and parents after thorough discussion. The formation of an Ethics Committee would lend support to the decision making. However, it is urged that prevention of low birth weight infants and congenital abnormalities would reduce the dilemma of the doctors.