Ethical Process and Medical Consideration on the Viability Limit of the Extreme Premature in Northeast Mexico

One of the big challenge of neonatologists is the decision on the viability and need of treatment of an extreme preterm newborn. Even with all the technological and scientific advances only preterm at 23 week of gestation are able to survive, but frequently with many complications. Neonatologist face an ethical dilemma and many of them put the decisions of initiate medical treatment as shared decisions between parents and practitioners. For many neonatologists in northeast of Mexico states the real viability limit is 26 gestational weeks. In this paper, we discuss the ethical principles involved in the decision of the limits of viability, the natural law paradigm, the deontology, the utilitarianism and the bioethics principles. The way this decision is constructed is not universal, because it is culturally influenced, and depends on experience, scientific and ethical knowledge. Many neonatologists do not know in deep the ethical principles needed to make these decisions and act more intuitively.