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. 2022 May 5;35(5):731-735.
doi: 10.1080/08998280.2022.2071073. eCollection 2022.

The limits of viability of extremely preterm infants

Michael H Malloy  1 , Leonard K Wang  1
Affiliations

The limits of viability of extremely preterm infants

Michael H Malloy et al. Proc (Bayl Univ Med Cent). .

Abstract

Shaeffer and Avery's textbook, Diseases of the Newborn (1971), estimated the limit of viability to be around 28 weeks' gestation and/or 1000 g. Contemporarily, however, attempts are being made to resuscitate infants as early as 22 weeks' gestation. Clearly the "limit of viability" is a moving target, and the acceptable risk of intervening to attempt to "save" these small infants/fetuses is a value judgment and not one that can be answered by science. Even though the dilemma is not one that can be resolved empirically, the emphasis on resolution continues to be one of demands for "further research" by critics as well as advocates for the care of these small infants. Patrick Romanell (1912-2002) was a major philosopher in the critical naturalist movement in the United States and internationally. His observations on the tragic quality of human life and the dilemmas associated between the conflicts of good vs good rather than the epic quality of good vs evil lend themselves well to understanding the conflicts involved in determining the limits of viability of extremely preterm infants.

Keywords: Critical naturalist philosophy; Patrick Romanell; extremely preterm infants; limits of viability.

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Figures

Figure 1.
Figure 1.
Infant mortality rate per 1000 live births, United States, 1915 to 1997. Source: Centers for Disease Control and Prevention.
Figure 2.
Figure 2.
Applying a critical naturalist approach to the tragic nature of the problem of a moving “limit of viability.”
See this image and copyright information in PMC

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