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'Do not resuscitate order' in neonatology: authority rules.

Ethical dilemmas in medicine should be resolved in light of four essential principles. To specify and guide concrete actions, it is necessary to 'supplement' these principles by certain other (substantive, authority and procedural) rules. The purpose of this paper is to establish and justify the authority rules regarding the order not to resuscitate newborns. The authority rules are intended to indicate who should decide, but they do not determine what should be chosen. Decision regarding newborn's treatment/letting die depends on medical and quality-of-life judgments. Parents, doctors, and society are considered to possess decisional authority in the matter. However, who in a given case should decide ought to be inferred from the reasoning which assumes, as its premises, the medical and quality-of-life judgments. The 'logical' syntax of this reasoning is presented in this paper.