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Surrogate decision making in crisis
  1. Dominic Wilkinson1,2,
  2. Thillagavathie Pillay3,4
  1. 1Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
  2. 2Newborn Care Unit, John Radcliffe Hospital, Oxford, UK
  3. 3Neonatal Unit, University Hospitals of Leicester NHS Trust, Leicester, UK
  4. 4Academic Institute of Medicine, University of Wolverhampton Faculty of Science and Engineering, Wolverhampton, UK
  1. Correspondence to Professor Dominic Wilkinson, Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK; dominic.wilkinson{at}


Care of the critically ill newborn includes support for the birth mother/parents with regular updates around the clinical condition of the baby, and involvement in discussions around complex decision-making issues . Discussions around continuation or discontinuation of life-sustaining are challenging even in the most straightforward of cases, but what happens when the birth mother is critically unwell? Such cases can lead to uncertainty around who should assume the parental role for these difficult discussions . In this round table discussion, we explore the ethical, moral and legal uncertainties raised by coincident severe maternal and neonatal illness in the context of surrogacy.

  • decision-making
  • clinical ethics
  • neonatology
  • reproductive medicine

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  • Twitter @Neonatalethics, @_tpillay

  • Contributors DW prepared the fictitious case, TP prepared the abstract. This case submission was based on discussions between TP and DW.

  • Funding DW was supported for this work by a grant from the Wellcome Trust 203132/Z/16/Z.

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

  • Competing interests None declared.

  • Patient consent for publication Not required.

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

  • Data availability statement There are no data in this work.

  • Author note This is a hypothetical composite case, containing elements of different real cases.

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