Abstract
[ Ethical problems in the management of high risk newborn] Recent progress in neonatal care have significantly improved the prognosis and chances of survival of critically ill or extremely preterm neonates and have modified the limits of viability. However, in some circumstances, when the child’s death can only be briefly postponed at the price of severe suffering, or when survival is associated with severe disabilities and an intolerable life for the child and his/her parents, it may not be appropriate to utilize all the armamentarium of neonatal intensive care. In such circumstances the limitation of intensive treatments (withholding or withdrawing) could represent a more human and reasonable alternative. This article examines and discusses the ethical principles underlying such difficult decisions, the most frequent situations in which these decisions might be considered, the role of parents in the decisional process and what are the opinions and behaviours of neonatologists of numerous European neonatal intensive units.
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