Is it wrong to save them? In the rapidly advancing field of neonatology, doctors have found miraculous ways to save even the tiniest of newborns. Many worry that the implications could be graver than they seem.
Debate over care for tiniest babies
Is it wrong to save them? In the rapidly advancing field of neonatology, doctors have found miraculous ways to save even the tiniest of newborns. Many worry that the implications could be graver than they seem.
Four weeks after conception a human embryo is about the size of a full stop. By week eight it is the size of a raisin, with a heartbeat, minuscule feet and a nose just beginning to grow. By week nine it has toes and by week 12 it has fingernails.
By week 16 a foetus can move and grow tiny hairs. By week 21 it has eyebrows and eyelashes. It finally resembles a tiny human.
At 22 weeks a baby is around the size of a sweet potato. Its lungs and kidneys are still developing. Its immune system is still fragile. And for most of history, babies born at 22 weeks - known as extremely premature - had no chance of survival outside the uterusThe organ in which a foetus (unborn baby) develops. Also known as the womb. .
Now, everything has changed. A baby born at 22 weeks has a chance of life, with some doctors saying as many as one third could survive where treatment is available.
However, many of the extremely premature babies saved today will develop long-term health problems, with as many as a quarter suffering from a "severe disability".1 And doctors are keen to emphasise that even though a third may now survive, that still means two-thirds will die.2
There is no predicting how any individual baby will fare with treatment. Doctors are responsible for a weighty moral decision: should they focus on relieving the baby's pain, or on resuscitating them to prolong their life with no way to determine the long-term implications?
With an outer layer of skin just a few cells thick, extremely premature babies are prone to injury and bleeding even at the gentlest touch. Their body temperature is volatileCan change quickly and unpredictably. and they can easily develop hypothermiaA dangerous drop in body temperature caused by exposure to cold.. Their immune systems are underdeveloped and they can suffer disastrous infections. They may be in unspeakable pain.
It cuts to the centre of one of humanity's greatest conundrumsConfusing or difficult problems.: how much is it worth to save a human life? Should we expend what could be considerable resources extending the life of a tiny, frail, struggling being whose quality of life might never be good?
Extremely premature babies need around-the-clock care. The pressures are immense and survival is still against the odds.
But some say that we have a moral obligation to do all we can to preserve each and every soul. As writer George Bernard Shaw said: "Life itself is the miracle of miracles."
Is it wrong to save them?
Yes: Just think of how much pain these tiny, helpless newborns are being subjected to, sometimes for months on end. Think of the grief and uncertainty of their parents. And after all of that, the odds of survival still remain slim.
No: We are not human if we do not do all we can to save a life. It is less a medical question than a philosophical one. That the vast majority of parents opt to actively treat their extremely premature babies shows that it is the only correct choice.
Or... The field cannot develop if we do not allow doctors to treat patients and refine their techniques. Perhaps now only one third of extremely premature newborns survive, but with time and experience treatments will develop and the odds will be better.
Uterus - The organ in which a foetus (unborn baby) develops. Also known as the womb.
Volatile - Can change quickly and unpredictably.
Hypothermia - A dangerous drop in body temperature caused by exposure to cold.
Conundrums - Confusing or difficult problems.
Debate over care for tiniest babies

Glossary
Uterus - The organ in which a foetus (unborn baby) develops. Also known as the womb.
Volatile - Can change quickly and unpredictably.
Hypothermia - A dangerous drop in body temperature caused by exposure to cold.
Conundrums - Confusing or difficult problems.