Abstract
Ethical, Legal, and Religious Aspects at the Border of Viability.
Highlights
TO THE TOPICImprovements in clinical care of the preterm infant have led to a dramatically improved outcome with respect to survival rates and survival without severe disability [1]
The mandatory provision of active care to the preterm infant is mostly based on gestational age, which is important when survival and survival without severe impairment are considered
While the constitutions and/or laws guarantee the right of the parents to care for their child, extremely preterm babies with severe diseases can have no real chance of survival, especially when born with a gestational age of
Summary
Improvements in clinical care of the preterm infant have led to a dramatically improved outcome with respect to survival rates and survival without severe disability [1]. Results from cohort studies display a wide variability of survival rates between different hospital units and countries This cannot be solely explained by the genetic background or therapeutic options available but needs to take into account center size, treatment experience and the attitude toward provision of active care [4, 5]. For selected disease entities like congenital diaphragmatic hernia, better prediction accuracy by the latest imaging techniques, data covering all relevant outcome aspects and the availability of long-term outcome facilitate parental counseling [6, 7] Providing another dimension for counseling, the potential of prenatal interventions and the latest advances in therapies with high risks for long-term health like ECMO in specialized centers need to be addressed adequately when counseling parents [8]. The quality of life is judged to be much better and the functional limitations less severe by former preterm infants and their parents than by the professional team of doctors and nurses [19]
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