Obstination déraisonnable et réanimation du nouveau-né

On 2 June 2009, the Nîmes administrative court condemned the Hospital of Orange (France) for unreasonable obstinacy after neonatal resuscitation. On 14 December 2002, an apparently stillborn child was resuscitated after approximately 30 minutes of fetal distress. Cardiac activity was recovered, but the child has since suffered from severe disabilities. The court did not find any fault committed by the hospital regarding maternal care. However, the hospital was sentenced to compensate for the injuries caused by unreasonable obstinacy. According to the court, the medical team should have taken into account the harmful neurological consequences of prolonged fetal distress. The court does not condemn the resuscitation effort itself, but its excessive length. The judge said that resuscitation was initiated “rightfully (…) from the child's birth”. This court ruling serves as a basis for reflection regarding the limits by which unreasonable obstinacy should be set. Current and past recommendations from the time of the incident advocate temporary intensive care, giving time to neonatal care teams to assess neurological status, and to eventually stop therapeutic efforts in case of a very pejorative prognosis. Decisions to not resuscitate cannot be taken in a neonatal emergency setting.