Extremely premature babies born at 22 weeks or less should not routinely receive intensive treatments, new British medical guidelines suggest.

The independent Nuffield Council on Bioethics issued the guidelines Wednesday and set the 22 week cut-off, saying babies between 22 and 23 weeks should not normally be resuscitated unless parents ask for it and doctors agree.

Such extremely premature births are rare and only about one per cent survive to leave hospital. The babies often develop severe disabilities, since those born before 25 weeks are very susceptible to breathing problems and cerebral hemorrhage because they are physiologically so immature.

"Natural instincts are to try to save all babies, even if the baby’s chances of survival are low," said Prof. Margaret Brazier, who chaired the committee that produced the guidelines.

"However, we don’t think it is always right to put a baby through the stress and pain of invasive treatment if the baby is unlikely to get any better and death is inevitable."

Assess cases on individual merits

While not all babies benefit from medical intervention if survival is unlikely, the British Medical Association disagrees with the council's strict cut-off, said Dr. Tony Calland, chair of the BMA's medical ethics committee.

Instead, each baby should be assessed on its own merits, Calland said.

"Patients have to be treated with considerable sympathy and sensitivity but also a clear sort of firmness about what the balances of a successful outcome are against the downsides of putting the child through really quite unpleasant treatment to maybe get no further forward," Calland told CBC Newsworld on Wednesday from Wye Valley, Wales.

Ethicist Margaret Somerville, professor of law and medicine at Montreal's McGill University, agreed each decision should be made on an individual basis. Parents are the primary people to have a say, although laws against denying treatment also come into play, she added. 

The main factor in making a decision to resuscitate is the best interests of the child, Calland said, such as if the treatment will help the child to lead life free of mechanical life support.

Religious communities respond to guidelines

There have been some discussions on the sensitive topic in Canada. The emotions of distraught parents, moral issues, the high costs of prenatal intensive care nurseries and caring for a severely disabled person throughout their lives all factor in, Somerville said.

Some religious leaders in Britain welcomed the report.

"This reaffirms the validity of existing law prohibiting euthanasia, and upholds the vital and fundamental moral principle that the deliberate taking of innocent human life is always gravely wrong," the Church of England House of Bishops and the Catholic Bishops' Conference of England and Wales said in a joint statement.

Britain's Society for the Protection of Unborn Children, a lobby group, called the guidelines "nothing short of eugenics."

The council was established to look at ethical issues of medical and biological research.