Ethical Dilemmas in Newborn Infants with Hypoxic Ischemic Encephalopathy

Ethical conundrums are common in neonatal medicine, particularly around continuing or withdrawing intensive treatment in a critically ill baby. A common scenario is a baby born with compromised oxygen delivery around the time of birth (perinatal asphyxia) leading to a condition named hypoxic ischemic encephalopathy (HIE) which can have a high probability of death or long-term neurologic disability. This article reviews the key ethical dilemmas that underpin the clinical management of babies with severe HIE. The discussions, however, could be relevant in any newborn with a life-threatening illness where withdrawal or redirection of intensive treatment is being considered.