BIOETHICAL VIEWS ON THE PROCEDURES IN EXTREMELY LOW BIRTH WEIGHT NEWBORNS

Thanks to technical advances in the last decades, the survival and the cure of newborns at the threshold of viability have been enabled. Since the attitudes towards the surviving lower limit in newborns have been changed, bioethical views on the procedures in extremely low birth weight newborns changed as well. In spite of the use of different technical advances, in some newborns the situation is hopeless. As for morbidity and mortality, the efficiency of a medical procedure in a newborn can be detected, but the final effect of a futile treatment in later life cannot be known. No newborn can be a subject of any diagnostic, therapeutic and experimental procedures if the parents are not fully informed and do not give their consent. The decision on what is best for the newborn is made by the doctor and the mother, namely parents. Euthanasia, whether direct or indirect, is widely discussed within the framework of medical bioethics on the daily basis, but very little is said about dysthanasia or futile treatment, when the life is prolonged without any hope of cure, with only pain and suffering for the patient. Recently, members of different religions and bioethicians agree more and more that dysthanasia should not be done, especially when it is the case of invasive neonatal therapy. On the basis of these discussions and guidelines, declarations and codexes of medical ethics, clinicians can agree not to keep alive a newborn who is below the surviving lower limit. Such a newborn should be provided with the essential care without invasive procedures, respecting their dignity and the right to death with dignity.