The ethics of resuscitation at borderline viability: when, if ever, is it ethically permissible to refuse a parental request?

[Note: The slide presentation is not available from this event.] Extremely preterm infants, born at the borderline of viability, face a high risk of death in the neonatal period despite efforts to keep them alive. And, among survivors, there is a risk of severe long-term neuro-developmental impairment. Clinicians involved in the care of these patients often question whether aggressive measures should always be taken, and under what circumstances, if any, it may be appropriate not to attempt resuscitation or provide intensive care technology. The relevant data, weaknesses of those data, relevant ethical principles, and an ethical framework for decision-making in this setting will be discussed. This framework should be more widely relevant, applicable to all such ethical decisions in pediatrics.