Aspetti di etica clinica nell'approccio al neonato prematuro

Clinical ethics issues in extreme prematurity The impressive technological development of the clinical neonatology raises some new ethical questions, that require the doctor to have a wider methodical and formal knowledge of the ethic case¿s analysis. First, to know how to conduct his professional practice, he will need an adequate awareness of the values intrinsically connected to the respect of the dignity and the human nature: the defence of the physical life, the quality of life prospectable for the new born and the proportionality of therapies. Under the guidance of these values every single medical decision could be gained as the result of four topics: indications for medical interventions for the specific clinical condition, patient¿s preference (or the preference of his representative in the cases in which is provided for) about therapeutic alternatives, actual and future supposed quality of life, contextual features that may be relevant for the clinical decision. The authors propose a ¿combined¿ approach to the extreme prematurity that would consent to rejoin the medical and the whole reason, considering either the future perspectives of the global health of the new-born and the lawful will of the relatives about the inevitable dangerousness of therapies.