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Decision-making at the border of viability: determining the best interests of extremely preterm infants
  1. Eric Vogelstein
  1. School of Nursing and Department of Philosophy, Duquesne University, Pittsburgh, Pennsylvania, USA
  1. Correspondence to Dr Eric Vogelstein, School of Nursing and Department of Philosophy, Duquesne University, 600 Forbes Ave., Pittsburgh, PA 15282, USA; vogelsteine{at}


This paper proposes and employs a framework for determining whether life-saving treatment at birth is in the best interests of extremely preterm infants, given uncertainty about the outcome of such a choice. It argues that given relevant data and plausible assumptions about the well-being of babies with various outcomes, it is typically in the best interests of even the youngest preterm infants—those born at 22 weeks gestational age—to receive life-saving treatment at birth.

  • foetal viability
  • neonatology
  • newborns and minors
  • perinatal morbidity
  • perinatal mortality

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  • Funding The authors have 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.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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