July 2, 2022

DO NOT RESUSCITATE VERY EARLY PREEMIES, SAYS UK REPORT

 Rejecting a call from British O&G doctors to consider legalising infant euthanasia, the Nuffield Council on Bioethics has recommended that active killing of newborn babies should not be allowed, no matter how serious their condition. However, the Council, whose reports are highly respected by the UK government, made its own controversial recommendation: to give only palliative care to all babies born before 22 weeks. It is extremely rare for babies born before 22 weeks to survive.

Only about 1% of babies born between 22 and 23 weeks live to leave hospital, says the Council. Normal practice should be not to give intensive care at this age, unless parents request it after a thorough discussion of the risks and if the doctors agree.

Natural instincts are to try to save all babies, even if the baby’s chances of survival are low," said Professor Margaret Brazier, who chaired the committee that produced the guidelines. "However, we don’t think it is always right to put a baby through the stress and pain of invasive treatment if the baby is unlikely to get any better and death is inevitable."

For babies born between 24 and 25 weeks, parents should have the final say in whether to give intensive care, says the Council.

Hanging over the report is the tragic case of Charlotte Wyatt, who was born in 2003 at 26 weeks. She was in very poor health and her doctors decided not to resuscitate her. However, her parents, who were devout Christians, objected and fought the case in the courts. The judge backed the doctors’ opinion, but Charlotte managed to survive, although with severe handicaps. The case put so much strain upon her parents’ marriage that they split up. Now neither of them appears to have the financial or personal resources to cope with Charlotte’s care. She may end up as a ward of the state.

Dr Vivienne Nathanson, the head of ethics at the British Medical Association, welcomed a framework for working with premature babies. "But," she said, "we would not be so happy about an overall recommendation on resuscitating babies at 22 weeks. We don’t believe you can make broad judgments. It has always been our position that every case is individual and every case should be judged on its own merits."

Although the Nuffield Council has dismissed the idea of infant euthanasia, support is growing. The leading news magazine The Economist supports a national debate. It suggests that caring for disabled children is extremely stressful for parents and expensive for the government. "Tiny babies do tug at the heartstrings but raising a severely impaired child is heartbreakingly hard. It is brave of doctors to dare to question whether they should save the life of each and every one," it asserts.