Bioethical aspects of palliative care of neonates

The widespread application of technical advances in medicine has greatly increased the chances of survival of vitally endangered newborns. When the situation is hopeless the decision should be made if there is a real need for invasive procedures, especially when treating newborns with serious malformations or extremely low birth weight. When therapy is helpless and it is of no benefit or results, or the quality of life is unacceptable only palliative care is left. When making such a serious decision, each case should be considered separately and both doctors and parents, as well as other medical staff, have to be accurately informed about the child’s condition, the possibilities of medical treatment and the possibilities of palliative care. The declaration of the rights of newborns state that a child with no prospects of improvement of health, despite all therapeutic advances, should receive the most needed care without invasive procedures (»comfort care») i.e. proper palliative care and all indispensable help, which would enable a quiet and dignified death.