By Gordon B Avery; Mhairi G MacDonald; Mary M K Seshia; Martha D Mullett
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Additional resources for Avery's neonatology : pathophysiology & management of the newborn
To date, reliance on professional self-regulation has not been effective in reducing multifetal pregnancy in the United States. There is currently a debate about whether social controls of infertility treatment and research are fitting for a pluralistic society that highly values reproductive liberty. The President's Council on Bioethics is now considering a set of very strong federal controls to protect human embryos and constrain infertility treatment (8). At this point, all could agree that women undergoing ART should be informed about the risks of multiple gestation and preterm delivery.
In a recent review, Carter and Stahlman broadly discuss the successes (and limits) of neonatal intensive care in the United States over the past 40 years (1). SOCIETAL AND PROFESSIONAL ISSUES Medicine is also accountable to society and to the international community. Critics may validly argue that American medicine and public policy have neglected primary prevention and fostered the technological imperative. To counter these criticisms, the moral priorities of NPM specialists need to include advocacy for comprehensive prenatal care, improved nutrition, prevention of premature delivery and appropriate family support and services for the infant after discharge.
Examples are the use of vascular endothelial growth factor (VEGF) and elastase inhibitors for reducing chronic lung disease (7,8,9). Worldwide, measures to combat perinatal and neonatal infections, lower the incidence of prematurity, and reduce maternal malnutrition will benefit outcomes without the need for new technology. The impact of basic public health measures is so dramatic that one World Health Organization (WHO) official described infant mortality as “a public health problem with medical aspects, not a medical problem with public health aspects” (10,11).
Avery's neonatology : pathophysiology & management of the newborn by Gordon B Avery; Mhairi G MacDonald; Mary M K Seshia; Martha D Mullett