The ethical problems that pertain to the care of extremely premature infants have been debated extensively during the last decades. Neonatology has undergone major advances in medical technology, pharmaceuticals, diagnostics, nursing procedures, and management policies, which during the last decades has resulted in the saving of both younger and light-weightier infants (infants at a very low birth weight), with steadily improved mortality rates. This has also resulted in more and more lives saved with varying degrees of illness, disabilities, and impairments, where the most severe affect the neurological functions, the lungs, the bowel, and the eyes.
The field of intensive care for extremely premature infants is surrounded by a number of uncertainties, for example the prognosis for future illness and impairment, the neurological plasticity, to relate illnesses and impairments to wellbeing (quality of life), the subjective responses to illness and impairment; where all these uncertainties makes decision-making more complicated. At the same time, it seems to be the case that all fields of healthcare have limited resources, and that the interests of others may be at stake depending on whether treatments is administered or withdrawn.
Along with an up-to-date picture of the situation in the care of the extremely preterms, the following considerations are in focus in my investigation, and will be given a thoroughly ethical, analysis: (i) Medically futile treatments; (ii) In the best interest of the child; (iii) Other's interests, and; (iv) Who should decide?
My work takes place under the guidance of my primary supervisor Bertil Strömberg, and my assistant supervisors Stellan Håkansson and Lars Samuelsson