The demands and limits of care--ethical reflections on the moral dilemma of neonatal intensive care.

Decisions regarding the care of deformed and retarded infants pose difficult ethical and moral dilemmas for both physicians and parents. Ethical inquiry regarding such questions must be concerned with how we see and understand the dilemma for conceptualization of the problem often shapes the decisions that are made. The fundamental issue that provides the background for the kind and amount of care defective newborns should receive is the obligation parents have to care for their children. New medical technology has so extended the limits of care that the extent of parental (and societal) obligation is unclear. In dealing with the problem of defective newborns, the action of both physicians and parents is determined in part by concern to act in a manner congruent with assumed roles and identity. With no moral consensus regarding the care of defective newborns, the doctor is put in a precarious position. What is revealed is how dependent medicine is on its underlying moral community to give it moral direction in instances of ambiguity and uncertainty.