• Roland Hentschel and Stella Reiter-Theil.
• Funktionsbereich Neonatologie und Intensivmedizin, Zentrum für Kinder- und Jugendmedizin, Universität Freiburg, Mathildenstrasse 1, Freiburg, Germany. roland.hentschel@uniklinik-freiburg.de
• Dtsch Arztebl Int. 2008 Jan 1; 105 (3): 475247-52.

IntroductionThe treatment of preterm infants at the lower margin of viability is carried out amid growing tension between increasing survival rates, uncertain clinical outcomes, and financial and ethical considerations. The three German speaking countries have released guidelines on this issue, based on a previous common guideline. That is why the differences in national guidelines between the three countries is of peculiar interest in respect of medical ethics.MethodsCurrent guidelines from Germany, Switzerland, and Austria were compared and similarities and differences discussed.ResultsThe three countries' guidelines follow broadly similar principles, with almost identical intellectual underpinnings and formulations. Some national differences are apparent, nevertheless.DiscussionAll three guidelines call for a pragmatic approach. National guidelines can only predetermine the framework, with long-term collection of sound local data on morbidity and mortality forming a prerequisite for decision-making, and also in discussions with parents.

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