Anemia of Prematurity - Portal Neonatal

MEDICAL AND LEGAL PITFALLS Section 6 of 7
As the number of ELBW infants increased in the postsurfactant era, so did questions regarding ethical,
economic, and legal dilemmas surrounding the care of the infants. The United States is no longer
alone in confronting neonatal-perinatal medical, legal, and ethical issues.
Management of anticipated delivery of an ELBW infant and subsequent care require the clinician to
make decisions "in the moment of clinical truth." Pellegrino successfully argues that morally defensible
difficult decisions must be made with available information and focus on "the morally right and good
thing to do in this patient." Information regarding mortality, morbidity, and prognosis changes with time.
Using the best information available, the clinician should manage the situation while taking into
account the family's wishes and "what is in the best interest of the patient." When resolving bioethical
dilemmas facing families and clinicians, the physician must address issues of futility, extension of the
dying process, respect for the dignity of life, and pain and suffering. From a legal standpoint in the
United States, government regulations exist based on child abuse laws enforced by individual states.
The question of what to do in the case of extreme prematurity (