In 2000, the French National Consultative Ethics Committee reported on ethical considerations regarding neonatal resuscitation.(243) They noted that in France extreme prematurity causes 50% of neonatal mortality and is associated with a high risk of serious sequelae. They reported that the survival rate for live births less than 24 weeks was 0%, and for those at 24 and 25 weeks, survival rates were 31% and 50% respectively. This is substantially less than U.S. figures. The committee noted the history and ethical dilemmas associated with extreme prematurity and stated that they did not aim to “set up rules or recommendations” but to help those involved find solutions by “highlighting the issues which need to be taken into account.” The first issue they emphasized was prevention, which they strongly believed was a priority for health policy. They had previously noted a recent increase in prematurity that they had, in part, related to late pregnancies, multiple pregnancies and faulty or poorly monitored medical prescription of ovulation induction drugs, and the transfer of several embryos during in vitro fertilization. They urged control and research in this area, as well as accountable improvements in prenatal services and further research into the causes and consequences of prematurity.

The next issue they wished to highlight was the practice of nonmaleficence. This was expressed as respect for four “categorical prescriptions”: do no harm, prevent a harmful effect, eliminate a harmful effect, and provide a beneficial effect.