Saving or Creating: Which Are We Doing When We Resuscitate Extremely Preterm Infants?

Am J Bioeth. 2017 Aug;17(8):4-12. doi: 10.1080/15265161.2017.1340988.


Neonatal intensive care units represent simultaneously one of the great success stories of modern medicine, and one of its most controversial developments. One particularly controversial issue is the resuscitation of extremely preterm infants. Physicians in the United States generally accept that they are required to resuscitate infants born as early as 25 weeks and that it is permissible to resuscitate as early as 22 weeks. In this article, I question the moral pressure to resuscitate by criticizing the idea that resuscitation in this context "saves" a human life. Our radical medical advancements have allowed us to intervene in the life of a human before it makes sense to say that such an intervention "saves" someone; rather, what the physician does in resuscitating and treating an extremely preterm infant is to take over creating it. This matters, I argue, because "rescues" are much more morally urgent than "creations."

Keywords: creation; extremely preterm infants; neonatal bioethics; procreative asymmetry; rescue.

MeSH terms

  • Attitude of Health Personnel*
  • Humans
  • Infant, Extremely Premature*
  • Infant, Newborn
  • Intensive Care Units, Neonatal*
  • Moral Obligations
  • Parents* / psychology
  • Prognosis
  • Religion
  • Resuscitation / ethics*
  • Resuscitation / psychology
  • Resuscitation Orders / ethics*
  • Resuscitation Orders / psychology