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Ethical issues in treatment of babies born at 22 weeks of gestation
  1. John D Lantos
  1. Children's Mercy Bioethics Center, Children's Mercy Hospital, Kansas City, Missouri, USA
  1. Correspondence to Dr John D Lantos, Children's Mercy Bioethics Center, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA; jlantos{at}


Many centres now report that more than half of babies born at 22 weeks survive and most survivors are neurocognitively intact. Still, many centres do not offer life-sustaining treatment to babies born this prematurely. Arguments for not offering active treatment reflect concerns about survival rates, rates of neurodevelopmental impairment and cost. In this essay, I examine each of these arguments and find them ethically problematic. I suggest that current data ought to lead to two changes. First, institutional culture should change at institutions that do not offer treatment to babies born at 22 weeks. Second, we need more research to understand best practices for these tiny babies.

  • ethics
  • neonatology
  • palliative care
  • health care economics and organizations

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  • Funding The author has not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

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