The unexpected birth of a critically ill baby raises many ethical questions for neonatologists. Some of these are obviously ethical questions, about whether to attempt resuscitation, and, if the baby is resuscitated and survives, whether to continue life sustaining interventions. Other ethical decisions are more related to what to say rather than what to do. Although less obvious, they are equally as important, and may also have far-reaching ramifications. This essay presents the story of a newborn with profound hypoxic-ischemic encephalopathy, and reviews decisions regarding resuscitation, withdrawal of mechanical ventilation, withdrawal of medically administered nutrition and hydration, and active euthanasia. An overview of the ethical issues at work at each decision point is presented, as well as guidance regarding discussions with parents throughout the process, including specific wording. This may serve as a helpful guide for ethical deliberation, and helpful scripting for parental discussion, in similar cases.

危重婴儿的意外出生给新生儿科医生带来了许多伦理问题。其中一些显然是伦理问题，关于是否尝试复苏，以及如果婴儿复苏并存活下来，是否继续进行生命维持干预。其他道德决策更多地与说什么而不是做什么有关。尽管不太明显，但它们同样重要，而且可能产生深远的影响。本文介绍了一名患有严重缺氧缺血性脑病的新生儿的故事，并回顾了有关复苏、停止机械通气，撤除医学上给予的营养和水合作用，以及主动安乐死。概述了每个决策点的工作伦理问题，以及在整个过程中与家长讨论的指导，包括具体措辞。在类似情况下，这可以作为道德审议的有用指南，也可以作为父母讨论的有用脚本。