Over the past 20 years two important changes that revolve around premature babies have taken place. The first has been a much-greater ability of medical advances to keep alive those born much before full-term. Another change that has been noted is the increased rate of prematurity, mainly due to the multiple births resulting from fertility treatment.
A report was published today by the Nuffield Council on Bioethics about premature babies. Its authors include those with medical, philosophical and legal expertise. The subject however is as controversial as the treatment of the chronically infirm at the end of their lives. Here too, the report's authors reject the active ending of neonatal life, even when that life is judged to be "intolerable".
According to the report although the interests of the baby are regarded as paramount, it lends weight to parents' views. The report especially encourages a broader debate by calling on interested bodies, such as the Royal College of Obstetricians and Gynecologists, to develop their own guidelines. However their advice on whether to institute intensive care appears rather prescriptive. Knowing the unreliability of assessing the maturity of these infants, deciding each case on its merit would be a better option, rather than lay down what should be done on a week-by-week basis. The British Medical Association, as do several others favor this more pragmatic approach.
Still another long over due debate is the issue regarding the 24 weeks set as the upper limit for terminating pregnancy by the 1967 Abortion Act which had been conveniently set aside by the advances in neonatal care.
When the treatment of babies born after 22 weeks of gestation is discussed, while disregarding the terms of that obsolete legislation it could only be seen as a glaring anomaly. Although the House of Commons may have recently rejected lowering the limit to 21 weeks this should not be the final word. The health care system and its experts should take the lead in persuading MPs to reopen the debate.