Periviable birth: Legal landscape in Indian jurisprudence

Area of Science:

• Medical Ethics
• Neonatal Law
• Indian Jurisprudence

Background:

• Periviability, the threshold for neonatal survival, presents complex medical, ethical, and legal issues, particularly in India with high preterm birth rates.
• Managing infants born at the margins of viability (<28 weeks gestation) in India faces significant legal and ethical hurdles.
• Current Indian legal framework lacks uniform consensus on viability thresholds.

Purpose of the Study:

• To critically examine the legal landscape surrounding the care of periviable neonates in India.
• To explore the medico-legal challenges faced by healthcare providers and families in neonatal resuscitation decisions.
• To analyze the implications of Indian jurisprudence and constitutional rights on periviable infant care.

Main Methods:

• Medico-legal analysis of Indian statutes and judicial precedents.
• Exploration of ethical considerations in neonatal resuscitation.
• Discussion of legal doctrines and their applicability to neonates.

Main Results:

• Indian law recognizes personhood and constitutional rights (Article 21) for all neonates at birth, irrespective of gestational age.
• Judicial precedents support life-saving interventions for viable neonates, affirming the right to care.
• Significant challenges exist due to lack of explicit guidelines, systemic infrastructure, cost constraints, and evolving tort liability.

Conclusions:

• Despite legal recognition of neonatal rights, navigating periviable infant care in India is complex due to legal uncertainty and resource disparities.
• Physicians and families face moral and legal dilemmas in resuscitation decisions without clear national guidelines.
• Addressing resource inequity and establishing clear legal frameworks are crucial for improving care for periviable neonates in India.