“Physicians have a moral duty to maintain a therapeutic relationship with their patients in order to sustain a sense of moral community. We submit it is ethically appropriate to allow a mother to retain the informed choice whether to resuscitate her periviable child immediately upon birth when, in conjunction with the physician, the determination of what is in the best interest of the baby is unclear (zone of ambiguity). If she elects the option of no resuscitation, this delivery room hospice approach provides a commonly justified alternative at older ages to standard neonatal‘comfort care’ measures in association with a painless death for her child. If delivery is imminent and aborting in the clinical setting is not a desirable option, we should consider respecting maternal autonomy, by allowing a vaginal delivery with the promise of offering opioids to assuage the dying process in a patient at high risk for lifelong handicap as with any other hospice condition.”

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