Yu V Y
Aust Paediatr J. 1987 Apr;23(2):97-103. doi: 10.1111/j.1440-1754.1987.tb02186.x.
Survival and disability rates of extremely low birthweight infants have significantly improved. Since it is impossible to give an accurate prognosis at the time of birth, all such live births should be resuscitated and curative treatment, including the use of life support measures when appropriate, promptly initiated. In the event that medical facts indicate curative efforts are futile or lack compensating benefit, they should be discontinued and palliative treatment, which provides symptomatic relief and comfort, should be introduced. The attending neonatologist has the primary role as advocate for the infant and medical advisor to the parents, while the parents act as surrogates for their infant. The shift in emphasis from curative to palliative treatment requires medical consensus among all those involved in the care of the infant and consent from the parents closely involved in this widely shared decision. The role of infant bioethics committees is one of advisor and consultant to this decision-making process. Legislation needs to uphold the primary prejudice in favour of life while conceding that discontinuation of curative treatment, which is no longer effective, and the provision of palliative treatment, are appropriate medical decisions in exceptional cases.
极低出生体重儿的存活率和致残率已显著提高。由于在出生时无法给出准确的预后，所有此类活产婴儿都应进行复苏，并及时启动包括在适当情况下使用生命支持措施在内的治疗。如果医学事实表明治疗措施无效或缺乏补偿性益处，则应停止这些措施，并引入提供症状缓解和舒适的姑息治疗。主治新生儿科医生作为婴儿的主要倡导者和家长的医学顾问，而家长则作为婴儿的代理人。从治疗性治疗向姑息性治疗的重点转变需要所有参与婴儿护理的人员达成医学共识，并得到密切参与这一广泛共识决定的家长的同意。婴儿生物伦理委员会的作用是这一决策过程的顾问。立法需要坚持有利于生命的首要偏见，同时承认在特殊情况下停止不再有效的治疗性治疗以及提供姑息性治疗是适当的医疗决策。
