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<title> Why All Prematurely Born Children Should Be Saved </title>
In an article published in Dagens Nyheter (Jan. 30, 2001) paediatrician Hugo Lagercrantz argues that not all prematurely born children should be saved. His arguments require a response and the stand- point of this essay is that all prematurely born children should be saved. It needs to be pointed out that this is a complex issue which cannot be dealt with fully on a few pages. This essay is a response to the arguments Dr. Lagercrantz has put forward in his article. Also note that the discussion only concerns Swedish conditions and that the chil-dren the discussion refers to are foremost those born between week 22 and 25.
To get the right perspective it is important to know that in Sweden only a hundred children a year are born between week 22 and 25. The first of Lagercrantz's two arguments to why not all prematurely born children should be saved and also one of the most common counter arguments is the risk of handicaps. There is a risk of neurological handicaps for prematurely born children but it is difficult to determine how great this risk is as follow-up studies are being made presently. Four physicians from Umeå and Uppsala claim in another article that there is 80 per cent chance of survival, without any severe handicaps as a conse-quence, for children born in week 25 (Dagens Nyheter, Feb. 18, 2001). Lagercrantz's comment on handicaps is the following. "To be born prematurely and be saved by 'courageous doctors' is unfortunate not only for the surviving child if he or she becomes severely handicapped but also for the whole family. One of the parents will most likely have to sacrifice the rest of his or her life for this child. Brothers and sisters will be second priority." Dr. Lagercrantz states in a few sentences that a handicapped person cannot live a happy and fulfilling life and that he or she will be a burden to the other members of the family. Dr. Lagercrantz says that he is a representative for the children. "...the child's right to be born to a good life", he writes. One might then ask oneself if he is the one who sets up the standards for what a good life is? There need to be a change in society's view of handicapped people. They must be looked upon as resources not burdens.
	Dr. Lagercrantz's second argument is that the lack of resources at Swedish hospitals makes it impossible to save all prematurely born children. He writes: "We [in the County of Stockholm] have 32 incubators...and there are around 10 000 children born a year." He compares these numbers to the number of incubators in Lille in France which is 60 and the same number of births. He also criticises the low wages for nurses working with children. Who would not agree with Dr. Lagercrantz on these points? It is a great problem that there are not enough resources at Swedish hospitals. There are no easy solutions to this problem but in the article, referred to earlier in this essay, an interesting view is put forward. The four physi-cians compare the numbers of prematurely born children who survive in Uppsala and Umeå to the corresponding numbers for other university hospitals. In Uppsala/Umeå 53 per cent of the children born in week 23 and 24 survive. The corresponding number for the other university hospitals is 44 per cent. Their conclusion is that the chance of survival depends on the physi-cian's attitude towards his or her task. A negative attitude will affect the whole team and their work. The problem with a lack of resources cannot be ignored but a changed attitude towards the task of saving prematurely born children is where we need to begin. 
	What Dr. Lagercrantz did not discuss at all in his article but which has to be mentioned is the patient's worth. Can we allow any external circumstances to affect what medical care a patient receives? A prematurely born child should be judged according to the same principles as all other patients; all humans should have the same worth.
	As a response to Dr. Lagercrantz's article this essay has dealt with the issue of why all prematurely born children should be saved. As stated early on in this essay this is a complex issue. The risk of handicaps exists but is not as great as one might think. More important to remember is that it is not such a "disaster" to be handicapped as Dr. Lagercrantz wants to depict it. The lack of resources is a problem but just as no other patient group should have to suffer because of this neither should prematurely born children. That must be the attitude; more resources not less medical care. What it comes down to is how we value life- pall humans should have the same worth.
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