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Death in the neonatal intensive care unit

The death of a baby still occurs many times a year in most neonatal units, often as a result of the withdrawal of intensive care. Although much has been written on this topic this month's contributions bring a wealth of common sense and experience to bear. Malcolm Chiswick has pointed out before that there are dangers in making assumptions about a baby's chances of survival from its appearance after weeks of intensive care.1 In this issue, Professor Chiswick thoughtfully discusses the articles on lingering death and consent for autopsy from McHaffie and her colleagues (pages 4and 8), adding much new material of his own (page 1). There can be few neonatologists who do not recognise at least one of his “unspoken signals” of staff distress, and most of us could probably add more. His honest approach to the need for analgesia and support during the dying process is helpful and refreshing. Withdrawal of intensive care based on a value judgement about a baby's future quality of life remains one of the most difficult and sensitive areas in neonatal medicine. Hazel McHaffie has already …

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