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Blanket policy disables Dutch

By Rob Williams, chief executive of BLISS - the premature baby charity If you happen to be in the Netherlands when you give birth to a premature baby born at less than 25 weeks' gestation, you will find it difficult to persuade the doctor standing over you to intervene to keep your baby alive. This is because the Dutch feel that the risk of the baby turning out to have severe disabilities is too high to justify medical intervention.
By Rob Williams, chief executive of BLISS - the premature baby charity If you happen to be in the Netherlands when you give birth to a premature baby born at less than 25 weeks' gestation, you will find it difficult to persuade the doctor standing over you to intervene to keep your baby alive.

This is because the Dutch feel that the risk of the baby turning out to have severe disabilities is too high to justify medical intervention.

Children with severe disabilities mean high education and health costs and ongoing social care needs, stretching out over decades to come.

Have the Dutch calculated that, on average, extremely premature babies are a loss-making proposition? Or is their policy based on a belief that the quality of life available to people with disabilities is so poor that the effort of sustaining them is not worth it?

Whatever their thinking, they have reached the wrong conclusion. The latest medical evidence shows that by the age of six, only one in five children who have survived the trauma of being born extremely premature has severe disabilities.

The remaining four will either show no sign of their lucky escape from an early death or will have only moderate disabilities of a kind that would not raise any serious questions about their quality of life.

In the UK we do not have a blanket policy on whether to put a baby on life support. It is up to the doctors and parents to decide what to do, based on whether the baby looks like it might do well.

At least, the Dutch policy allows doctors to avoid the stress of making difficult judgement calls under extreme time pressure. But doctors are the only ones who benefit from such a simplistic approach.

In my view a baby's life is too important to be left to a blanket policy decision. And the Netherlands is best avoided until well into the third trimester.



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