Myelomeningocele and medical ethics

Abstract

Throughout history, the treatment of infants born with serious neurological and physical medical ailments has been debated: to treat or not to treat? In the early nineteenth century, little could be done for these infants who often either died during the perinatal period or succumbed to the natural progression of their disease. With improvements in medical diagnosis and treatment, a shift in attitude has led to more aggressive medical intervention in the treatment of affected newborns and an ability to treat certain conditions in the prenatal period [1-3]. Despite our success in treating younger and younger babies, some cases nevertheless result in children with a degree of physical or mental disability, many of whom could not have been treated as recently as 50 years ago [4]. Social and financial stresses are thus imposed on the families of these children as well as on society as a result of these successful treatments. Furthermore, a conflict remains between the benefits that the child gains from being sustained, albeit in a disabled state, and the quality of life the child experiences because of the treatments necessitated by his/her disease. Critical issues and arguments must be considered on all sides of the debate when considering medical intervention in severely ill infants. © 2008 Springer-Verlag Italia.