Great Ormond Street Hospital, Great Ormond Street, London WC1N 3JH, UK.
Semin Fetal Neonatal Med. 2013 Apr;18(2):105-10. doi: 10.1016/j.siny.2012.10.011. Epub 2012 Nov 29.
Decisions regarding the end-of-life care of neonates, especially those at the limits of viability, cannot be made on the basis of clinical facts alone. They should take into account the values and beliefs of all concerned. Application of classical moral theories may take insufficient account of the interests of small babies. Due consideration needs to be given to the value and quality of babies' lives, their best interests, and the interests of their parents in practical decision-making. Life-sustaining treatments can be withheld or withdrawn if they no longer serve the baby's best interests, but active euthanasia (though an acceptable practice in The Netherlands) remains illegal in the UK. Withdrawal of clinically assisted nutrition and hydration can be ethical but remains controversial. If organ donation in UK neonates is to become established it will need to respond to the changing characteristics of neonatal deaths in ways that are ethically and socially sensitive.
关于新生儿临终关怀的决定，特别是那些接近生存极限的新生儿，不能仅基于临床事实做出。它们应该考虑到所有相关人员的价值观和信仰。经典道德理论的应用可能没有充分考虑到小婴儿的利益。在实际决策中，需要充分考虑婴儿生命的价值和质量、他们的最佳利益以及父母的利益。如果生命维持治疗不再符合婴儿的最佳利益，可以停止或撤回，但安乐死（尽管在荷兰是一种可接受的做法）在英国仍然是非法的。停止提供临床辅助营养和水合作用在伦理上是可以接受的，但仍存在争议。如果英国新生儿的器官捐赠要得到确立，就需要以伦理和社会敏感的方式应对新生儿死亡特征的变化。
