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American Journal of Bioethics.

Should Extremely Premature Babies Get Ventilators During the COVID-19 Crisis?

In a crisis, societal needs take precedence over a patient’s best interests. Triage guidelines, however, differ on whether limited resources should focus on maximizing lives or life-years. Choosing between these two approaches has implications for neonatology. Neonatal units have ventilators, some adaptable for adults. This raises the question of whether, in crisis conditions, guidelines for treating extremely premature babies should be altered to free-up ventilators. Some adults who need ventilators will have a survival rate higher than some extremely premature babies. But surviving babies will likely live longer, maximizing life-years. Empiric evidence demonstrates that these babies can derive significant survival benefits from ventilation when compared to adults. When “triaging” or choosing between patients, justice demands fair guidelines. Premature babies do not deserve special consideration; they deserve equal consideration. Solidarity is crucial but must consider needs specific to patient populations and avoid biases against people with disabilities and extremely premature babies.

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Volume 20, Issue 7
July 2020

Target Articles.

Ethical Challenges Arising in the COVID-19 Pandemic: An Overview from the Association of Bioethics Program Directors (ABPD) Task Force Amy L. McGuire, Mark P. Aulisio, F. Daniel Davis, Cheryl Erwin, Thomas D. Harter, Reshma Jagsi, Robert Klitzman, Robert Macauley, Eric Racine, Susan M. Wolf, Matthew Wynia, Paul Root Wolpe & The COVID-19 Task Force of the Association of Bioethics Program Directors (ABPD)
Eliminating Categorical Exclusion Criteria in Crisis Standards of Care Frameworks Catherine L. Auriemma, Ashli M. Molinero, Amy J. Houtrow, Govind Persad, Douglas B. White & Scott D. Halpern
Should Extremely Premature Babies Get Ventilators During the COVID-19 Crisis? Marlyse F. Haward, Annie Janvier, Gregory P. Moore, Naomi Laventhal, Jessica T. Fry & John Lantos
COVID in NYC: What We Could Do Better Tia Powell & Elizabeth Chuang
Ethics Lessons From Seattle’s Early Experience With COVID-19 Denise M. Dudzinski, Benjamin Y. Hoisington & Crystal E. Brown