Value-based neonatology (VBN): a new ethical paradigm for newborn care

A few months ago, the Lancet Commission on the Future of Neonatology laid the foundations for boosting research and development in this field, ensuring modern, effective neonatal medicine. Worried about curing neonates as it was done 20 years ago, the Commission document provides a long list of actions for the various stakeholders. Several ethical issues arise in the background, which may go unnoticed, particularly by clinicians busy with routine clinical care. This review highlights some issues, explains the ethical reasoning behind the Lancet Commission document, and promotes the adoption of "Value-Based Neonatology". The value-based approach is already being used in other medical specialties, and we set out the framework for its application in neonatal medicine here.Conclusion: We believe that the full introduction of VBN in neonatal clinical care and research will help changing practicing, because it would be hopefully useful to optimise resource allocation and eventually decrease the areas of uncertainties.