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'No revival' for premature babies 'No revival' for premature babies
(20 minutes later)
Babies born at or before 22 weeks should not be resuscitated or given intensive care, a report says.Babies born at or before 22 weeks should not be resuscitated or given intensive care, a report says.
The recommendation is being put forward by the Nuffield Council on Bioethics, which considers ethical questions raised by advances in medical research.The recommendation is being put forward by the Nuffield Council on Bioethics, which considers ethical questions raised by advances in medical research.
For those born after 23 weeks, the recommendation is that doctors should review the situation with the parents and take their wishes into account.For those born after 23 weeks, the recommendation is that doctors should review the situation with the parents and take their wishes into account.
The report has been released after two years of research.The report has been released after two years of research.
No two babies - at 22 or 23 weeks - are exactly the same Dr Vivienne NathansonBritish Medical Association Saving premature babies 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 Professor Margaret BrazierNuffield Council on Bioethics Saving premature babies It also gives guidance on how parents should resolve arguments with doctors over the fate of their babies.
It will also give guidance on how parents should resolve arguments with doctors over the fate of their babies.
The report comes against a backdrop of medical advances which have been able to sustain the lives of very premature babies.The report comes against a backdrop of medical advances which have been able to sustain the lives of very premature babies.
However, research shows that many of these babies do not live very long, or go on to develop severe disability.However, research shows that many of these babies do not live very long, or go on to develop severe disability.
Part of the problem is that despite advances in modern medicine, it is not always obvious to doctors which babies will survive and thrive.Part of the problem is that despite advances in modern medicine, it is not always obvious to doctors which babies will survive and thrive.
The Nuffield Council on Bioethics inquiry also looked at longer-term support for families, and resource implications for the NHS. Professor Margaret Brazier, who chaired the committee that produced the guidelines, said: "Natural instincts are to try to save all babies, even if the baby's chances of survival are low.
"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."
The inquiry also looked at longer-term support for families, and resource implications for the NHS.
Many premature birthsMany premature births
Bliss, the premature baby charity, is campaigning for one to one neonatal intensive care, and for decisions to made based on clinical reasoning, and not financial constraints.Bliss, the premature baby charity, is campaigning for one to one neonatal intensive care, and for decisions to made based on clinical reasoning, and not financial constraints.
The charity said the UK had the highest rate of low birth weight babies in Western Europe.The charity said the UK had the highest rate of low birth weight babies in Western Europe.
About 300 babies are born in the UK each year at 23 weeks.About 300 babies are born in the UK each year at 23 weeks.
They have a 17% survival rate, compared with 50% for those born at 25 weeks.They have a 17% survival rate, compared with 50% for those born at 25 weeks.
Figures suggest that no baby survives at 21 weeks, while only 1% survive at 22 weeks.Figures suggest that no baby survives at 21 weeks, while only 1% survive at 22 weeks.
Vivienne Nathanson, head of ethics at the British Medical Association, said it would be wrong to make a decision based purely on the gestational age of the baby. Andy Cole, Bliss chief executive, said: "While only a small percentage of infants in the UK are born at 24 weeks or less, it is essential that every baby should be treated as an individual and given the best and most appropriate care at the point of life.
"We strongly endorse the recommendation that assessment of care for the most vulnerable infants needs to be a joint decision between parents and clinicians."
All babies different
No two babies - at 22 or 23 weeks - are exactly the same Dr Vivienne NathansonBritish Medical Association
However, Vivienne Nathanson, head of ethics at the British Medical Association, warned it would be wrong to make a decision based purely on the gestational age of the baby.
She told She told BBC Radio 4's Today programme: "I think the important issue here is that the doctor has a duty to both the parents and the baby - and what the parents want is that the baby is considered as an individual.She told She told BBC Radio 4's Today programme: "I think the important issue here is that the doctor has a duty to both the parents and the baby - and what the parents want is that the baby is considered as an individual.
"No two babies - at 22 or 23 weeks - are exactly the same.""No two babies - at 22 or 23 weeks - are exactly the same."
There are about 250 units in the UK offering neonatal intensive care, high dependency and special care.There are about 250 units in the UK offering neonatal intensive care, high dependency and special care.
Earlier this month the Royal College of Obstetricians and Gynaecologists said it wanted a discussion over whether "deliberate intervention" to cause death in severely disabled babies should be legalised.Earlier this month the Royal College of Obstetricians and Gynaecologists said it wanted a discussion over whether "deliberate intervention" to cause death in severely disabled babies should be legalised.
The Nuffield Council on Bioethics was established in 1991 to examine ethical questions raised by advances in biological and medical research.The Nuffield Council on Bioethics was established in 1991 to examine ethical questions raised by advances in biological and medical research.