Law and ethics at the border of viability

The Supreme Court of Texas in the case of Miller v. HCA announced a rule in 2003 ( 118 s.w. 3d 758) that a physician attending the delivery of a severely premature infant may provide life-sustaining treatment for that infant under 'emergent circumstances' as a matter of law without first obtaining parental consent. This paper examines issues of law and ethics relevant to decisions about infant resuscitation at the border of viability. It is argued that there is typically no emergency when infants are delivered at 23 weeks gestation, and parents should be asked for informed consent before resuscitation in the delivery room.