Selecting neonatal ethics.

Abstract

Nontreatment of handicapped newborns has disturbed American society, prompting heated debate and new attempts by government at regulation. Robert Weir's new book reviews the elements of this controversy as argued by concerned doctors, lawyers and ethicists. Unfortunately, we do not know the magnitude or scope of the problem. We know little about how often or under what circumstances physicians practice nontreatment. In discussing the issues, Weir and others have paid inadequate attention to medical uncertainty. The inability to accurately predict outcome makes clinical judgment harder than most philosophers and others acknowledge. Many legal arguments are outdated. The concept of personhood Weir and ethicists invoke confounds decision making. Complex or uncertain medicomoral dilemmas will not be resolved more easily by ethics committees. This procedural solution to a substantive quandry creates new problems. More attention must be paid to patients' current and future suffering when deciding whether to treat severely handicapped infants.