Creating an ethical environment for parents and health providers dealing with the treatment dilemmas of neonates at the edge of viability

Parents who deliver an infant on the edge of viability are often poorly prepared for the many ethical decisions that will confront them. Physicians will give mothers who are in early labor a quick synopsis of what they can do to treat this very preterm infant, but do not always have the time to explain the ethical ramifications of the decisions that will be made. Furthermore, these parents are often in physical and emotional distress, which is not conducive to an important discussion regarding the quality of life of their infant. These periviable infants, born between 22 and 24 weeks, have a great variation in probability of survival with and without morbidity. Parents need to be given statistics and medical probabilities so they can make informed, ethical decisions regarding their child's future. In the middle of an emergency delivery is not the time to have these important ethical discussions. Due to these problems, parents should be given information earlier in the pregnancy in order to be more informed in the event that they have a baby born at the limits of viability.