Neonatal resuscitation and intensive care may need certain restrictions and limits if it is to be in the best interests of the newborn infant. There are circumstances in which treatments that merely sustain “life” neither restore health nor confer other benefit and hence are no longer in the child's best interest. Imposing resuscitation or advanced critical care medicine on an infant requires a greater justification than mere survival. There must be a rationale on which doctors decide the infant may face not merely pain and suffering, but rather a realistic chance of long-term survival without devastating sequelae. Survivability is not the only issue at stake. Both suffering inflicted by medical procedures and severe long-term morbidity might be considered an even greater tragedy than death. This issue poses problems across multiple medical specialties, not just neonatology, and the ethical principles regarding resuscitation and advanced critical care of newborns are not different from those applicable to older children and adults. However, as the body of a newborn, particularly that of an extremely preterm infant, is still developing, both vulnerability and the potential for adaptive recovery exceed those of older children or adults.

Opinions and beliefs

The very nature of medicine implies inherent interference with the natural course of a disease. Doctors have powerful means, the use of which must be wisely considered. However, withholding or withdrawing medical care from patients with a poor prognosis raises challenging ethical, moral, legal, and emotional dilemmas.