Sách giáo khoa đầu tiên về đẻ non của Hoa Kỳ được xuất bản năm 1922. Năm 1952 Bác sỹ Virginia Apgar mô tả hệ thống thang điểm Apgar như là một phương tiện đánh giá tình trạng trẻ sơ sinh. | BIOETHICS viewed this as more than sufficient evidence of the disproportionate burden that awaited this child to justify a decision to withhold resuscitation. 194 This conclusion was made even though should the infant have survived the statistical risk of a major disability was considerably less than not having a major disability. Furthermore should the major neurological complications of extreme prematurity occur prediction of the degree of disability may be difficult particularly during the early stages after birth. Paris also proposed a popular fallacy argument by stating that treatment is based on objective criteria such as birth weight throughout Europe. Even if this was totally true which it is not as there is much variability see Section I it is not a moral justification. He also wrote that because the baby was described as lifeless hypotonic hypoxic purpleblue with no grasp or grimace at birth that this should have precluded resuscitation even though the baby had a heart rate of 90. Many extremely preterm infants have this appearance at birth. The reasoning that the baby s appearance should have precluded resuscitation begs the question are infants such as these who are resuscitated at birth more likely to have severe neurologic disability if they survive Or if they die are they more likely to have a long lingering dying process The scientific literature appears to support an answer of no to both these questions. 49-53 157 Whereas considering the interests of the infant is paramount this is not to discount the interests of others. Parents who are left to raise a disabled extremely preterm infant suffer significant stress. They may enter a morass of frustration guilt denial anger and disbelief that may be rekindled during their years of caring. It should be argued that if the state has a strong duty to protect the vulnerable and the susceptible then it also has an obligation to provide social educational psychological and economic support for those who care
