Ethical Challenges in Neonatal Life Support

Advancements in neonatal intensive care have dramatically improved survival of extremely preterm and critically ill newborns while simultaneously intensifying ethical dilemmas surrounding futility, parental authority, best interests of the child, and resource allocation.This narrative review examines the application of the four principles of biomedical ethics to contemporary neonatal decision-making, landmark legal cases [Baby Doe, Baby K, Groningen Protocol, Charlie Gard, and the Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) babies], and persistent controversies in periviability, complex congenital anomalies, neonatal euthanasia, and emerging biotechnologies.Special attention is given to prognostic uncertainty, disability-rights critiques, global disparities, the risks and promises of artificial intelligence (AI) in prognostication, and the ongoing prohibition of heritable genome editing.The article concludes that neonatal ethics remains deeply contested because it confronts fundamental societal values regarding suffering, disability, and the worth of nascent human life, and calls for enhanced international collaboration, evidence-based shared decision-making, and culturally sensitive consensus guidelines, with a potential leadership role for the Global Newborn Society (GNS).