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Surrogate uncertainty: who decides?
  1. Dominic Wilkinson1,2
  1. 1 Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
  2. 2 Newborn Care Unit, John Radcliffe Hospital, Oxford, UK
  1. Correspondence to Professor Dominic Wilkinson, University of Oxford, Oxford OX1 2JD, UK; dominic.wilkinson{at}

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In the case that triggered this round-table discussion there are three separate factors that contribute to moral uncertainty.1 First, the infant, baby T, is extremely premature with suspected brain injury and potentially poor prognosis. Second, the gestational mother is critically unwell herself and her outlook is guarded. Third, as linked commentaries make clear, the legal status of the intended parents (IP) is complex and ambiguous.2 3 Any of these factors on their own would be enough to generate ethical complexity and distress in the neonatal intensive care unit. The combination of the three is likely to be highly stressful for all concerned.4

Commentaries on the case emphasise the complex legal questions and the potential need to involve the court. One resource that is not mentioned is the potential value of clinical ethics input in such a case. This is complementary to the need for legal advice. Its aim would be to help think through the specifically ethical, rather than legal questions.

There are several things that I would aim to clarify if chairing a clinical ethics discussion on the case.

First, it may be useful to draw on the concept of the …

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  • Contributors This single-author paper was written and conceived by DW.

  • Funding This research was funded in whole, or in part, by the Wellcome Trust (203132/Z/16/Z).

  • Disclaimer The funders had no role in the preparation of this manuscript or the decision to submit for publication.

  • Competing interests None declared.

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

Linked Articles

  • Clinical ethics
    Dominic Wilkinson Thillagavathie Pillay
  • Commentary
    Bianca Jackson Kirsty Horsey Andrew Spearman

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