Attitudes of Australian neonatal paediatricians to the treatment of extremely preterm infants.

A questionnaire survey was carried out to identify areas of consensus or disagreement in the attitudes and practices of Australian neonatal paediatricians with regard to the treatment of extremely preterm infants. Considerable variation was found in the estimated chances of survival and disability among respondents. The majority of neonatal paediatricians advocated prompt resuscitation and initiation of neonatal intensive care at birth, although all believed life-support treatment should be withdrawn in those instances where medical complications develop resulting in near certainty of death or life with total incapacity. The predominant view was for parents to be involved in the decision-making process for withdrawal of life-support and for the neonatal intensive care policy to be made known to the parents. Information from this survey which raised concerns included the variability in the estimate of the potential for survival, the lack of relevance of the law to everyday practices in the neonatal intensive care units, the small minority of respondents who felt that life-and-death decisions should be made by medical staff alone, and the reluctance of some neonatal paediatricians to inform parents about the policies of their unit.