Decisions about whether to start intensive care in extremely premature babies
Current practice in most neonatal units in the UK is usually to resuscitate a baby if the outcome is uncertain and provide intensive care until the outlook is clearer. However, as life-saving treatments can be invasive and may cause suffering, it is difficult to know whether this is the right course of action if the baby is unlikely to benefit.
For this reason, the Working Party gave careful consideration to whether or when intensive care should be withheld from babies born extremely prematurely. We concluded that the considerable variability in outcome for such babies meant that a complete ban on intensive care would be an unjustifiable infringement of the interests both of the child and their parents. However, clearer guidance on whether to give intensive care to extremely premature babies would help parents and doctors make more informed decisions about treatment in individual situations.
We propose below a set of guidelines to provide a basis of discussion for professional bodies and parents. The guidelines should be reviewed regularly and revised to reflect any changes in outcomes for extremely premature babies.