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To the Editor.—
McGraw and Perlman are to be commended for exploring this issue.1 I agree that a possible explanation for the changing attitude may partly be related to the observation that support for the best-interest standard for neonates is diminishing in favor of parental autonomy. I would contend, however, that in certain circumstances, more intensive intervention can meet both the best-interest-of-the-child standard and the futility-of-care standard.
For trisomy 18, studies have shown that 5% to 10% survive the first year.2 Perhaps this low degree of survivability could be called “lethal,” but …
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