Anne Winyard, a member of the Working Party, summarises the main findings of the Report which examines the ethical, social and legal issues which may be raised in critical care decision-making and makes practical recommendations for future policy and practice. The Report provides guidelines to help parents and professionals make decisions about instituting intensive care for extremely premature and seriously ill babies.
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References
1.
MacfarlaneA, MugfordM.Birth Counts: Statistics of pregnancy and childbirth, Vol 2. 2nd edition.London: The Stationery Office, 2000
2.
The Nuffield Council on Bioethics examines ethical issues raised by new developments in biology and medicine. Established by the Nuffield Foundation in 1991, the Council is an independent body, funded jointly by the Foundation, the Medical Research Council and the Wellcome Trust.
3.
For example, we were told that on average over 200 blood samples and other procedures are carried out on a baby in the first two weeks of life in neonatal intensive care.
4.
Costeloe K, Hennessy E, Gibson AT, Marlow N, Wilkinson AR and the EPICure study group.The EPICure study: Outcomes to discharge from hospital for babies born at the threshold of viability. Pediatrics2000; 106: 659–71
5.
In England in 2004-05, the number of births was 584,000, of which 2310 babies (approximately 0.4%) were born at or below 26 weeks’ gestation.
Marlow N, Wolke D, Bracewell MA, Samara M for the EPICure Study Group.Neurologic and developmental disability at six years of age after extremely preterm birth. New Engl J Med2005; 352: 9–19
8.
Seven percent of all children have a disability or long-term condition, which is a total of 770,000 children and young people in the UK. The Parliamentary Hearings on Services for Disabled children, full report is available at: www.edcm.org.uk/pdfs/parl_hearings_reportamended.pdf
9.
For example, the Trent Neonatal Survey.
10.
MarkestadT, KaaresenPI, RonnestadAon behalf of The Norwegian Extreme Prematurity Study Group. Early death, morbidity and need of treatment among extremely premature babies. Pediatrics2005; 115: 1289–98
11.
The doctrine of ‘double effect’.
12.
In England and Wales in 2004-05, 124 terminations were carried out after 24 weeks of gestation, out of a total of 185,415: that is, less than 0.1% were carried out after 24 weeks.
13.
A procedure where the fetus is killed with an injection to stop the heart working before it is delivered in late abortions (at 22 weeks and later). It is recommended by the Royal College of Obstetricians and Gynaecologists guidelines, and women usually agree to have it. The procedure pre-empts the possibility of dilemmas about whether a baby born alive after a termination should be resuscitated.
