Lantos John D
Children's Mercy Bioethics Center, Children's Mercy Hospital, Kansas City, Missouri, USA
Arch Dis Child. 2021 Dec;106(12):1155-1157. doi: 10.1136/archdischild-2020-320871. Epub 2021 Apr 14.
Many centres now report that more than half of babies born at 22 weeks survive and most survivors are neurocognitively intact. Still, many centres do not offer life-sustaining treatment to babies born this prematurely. Arguments for not offering active treatment reflect concerns about survival rates, rates of neurodevelopmental impairment and cost. In this essay, I examine each of these arguments and find them ethically problematic. I suggest that current data ought to lead to two changes. First, institutional culture should change at institutions that do not offer treatment to babies born at 22 weeks. Second, we need more research to understand best practices for these tiny babies.
现在许多医疗中心报告称，孕22周出生的婴儿中有半数以上存活，且大多数幸存者神经认知功能完好。然而，许多医疗中心仍不为如此早产的婴儿提供维持生命的治疗。不提供积极治疗的理由包括对存活率、神经发育障碍发生率和成本的担忧。在本文中，我审视了这些理由，发现它们在伦理上存在问题。我认为，当前的数据应带来两点改变。第一，对于不为孕22周出生的婴儿提供治疗的机构，其制度文化应该改变。第二，我们需要更多研究来了解针对这些极小婴儿的最佳治疗方法。
