Sociology and Ethics
At the turn of the 20th century, there was little that a physician could do for premature infants except keep them warm, feed them breast milk, isolate them from strangers and each other, weigh them daily, and hope for the best. In fact, many premature infants were cared for at home, with incubators that were built from scrap materials as necessary or rented for the occasion.
As technology became more complex, and care of infants became the exclusive domain of specialized units within hospitals, the sociology and ethics of neonatal care became more complex as well. Many tragic episodes in the history of neonatology testified to the dangers of aggressive treatment for treatment’s sake, or the rash adoption of new techniques or drugs without carefully controlled trials. Parents and breastmilk were excluded in favor of formulas and antiseptic, controlled environments.
As we enter the 21st century, the importance of parental participation and breastmilk are again fully recognized. “Rooming in” and “Kangaroo care” are bywords. But the questions of “who is the best advocate for the baby” and “when is the extraordinary use of technology appropriate” and “what is an acceptable outcome” have become increasingly unclear, blurred further by the application of concepts like “cost-effectiveness” to critical care, even as our ability to rescue incredibly small infants has continued to improve.
We’ve listed a number of books and articles on the pages in this section for further reading in the sociology and ethics of neonatology. A variety of viewpoints are represented here and no endorsement is implied for any of them.