{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T05:18:16Z","timestamp":1772255896544,"version":"3.50.1"},"reference-count":37,"publisher":"Elsevier BV","issue":"2","license":[{"start":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T00:00:00Z","timestamp":1646092800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T00:00:00Z","timestamp":1646092800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T00:00:00Z","timestamp":1646092800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T00:00:00Z","timestamp":1646092800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T00:00:00Z","timestamp":1646092800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T00:00:00Z","timestamp":1646092800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.fr","clinicalkey.jp","clinicalkey.com.au","clinicalkey.es","clinicalkey.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Seminars in Perinatology"],"published-print":{"date-parts":[[2022,3]]},"DOI":"10.1016\/j.semperi.2021.151531","type":"journal-article","created":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T02:09:17Z","timestamp":1636423757000},"page":"151531","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":6,"title":["Ethical implications of the shifting borderline of viability"],"prefix":"10.1016","volume":"46","author":[{"given":"John D.","family":"Lantos","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"issue":"7","key":"10.1016\/j.semperi.2021.151531_bib0001","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1056\/NEJMoa1605566","article-title":"Survival and neurodevelopmental outcomes among periviable infants","volume":"376","author":"Younge","year":"2017","journal-title":"N Engl J Med"},{"issue":"22","key":"10.1016\/j.semperi.2021.151531_bib0002","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1056\/NEJM199311253292201","article-title":"The limit of viability\u2013neonatal outcome of infants born at 22 to 25 weeks' gestation","volume":"329","author":"Allen","year":"1993","journal-title":"N Engl J Med"},{"issue":"4","key":"10.1016\/j.semperi.2021.151531_bib0003","doi-asserted-by":"crossref","first-page":"e1130","DOI":"10.1542\/peds.2005-2724","article-title":"Morbidity and mortality of infants with very low birth weight in Japan: center variation","volume":"118","author":"Kusuda","year":"2006","journal-title":"Pediatrics"},{"issue":"12","key":"10.1016\/j.semperi.2021.151531_bib0004","doi-asserted-by":"crossref","first-page":"1188","DOI":"10.1001\/jama.2019.2021","article-title":"Association between year of birth and 10 year survival among extremely preterm infants in Sweden, 2004-2007 and 2014-2016","volume":"321","author":"Norman","year":"2019","journal-title":"JAMA"},{"issue":"2","key":"10.1016\/j.semperi.2021.151531_bib0005","doi-asserted-by":"crossref","first-page":"F190","DOI":"10.1136\/archdischild-2018-316770","article-title":"Active perinatal care of preterm infants in the German neonatal network","volume":"105","author":"Humberg","year":"2020","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"4","key":"10.1016\/j.semperi.2021.151531_bib0006","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1097\/AOG.0b013e31824b1a03","article-title":"Improving survival of extremely preterm infants born between 22 and 25 weeks of gestation","volume":"119","author":"Kyser","year":"2012","journal-title":"Obstet Gynecol"},{"issue":"5","key":"10.1016\/j.semperi.2021.151531_bib0007","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1097\/AOG.0000000000001101","article-title":"ACOG obstetric care consensus No. 3 summary: periviable birth","volume":"126","year":"2015","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.semperi.2021.151531_bib0008","unstructured":"K. Barrington Another extremely flawed guideline on perinatal deliveries. www.neonatalresearch.org. October 26, 2015. Accessed Feb 7, 2018."},{"issue":"19","key":"10.1016\/j.semperi.2021.151531_bib0009","doi-asserted-by":"crossref","first-page":"1801","DOI":"10.1056\/NEJMoa1410689","article-title":"Between-hospital variation in treatment and outcomes in extremely preterm infants","volume":"372","author":"Rysavy","year":"2015","journal-title":"N Engl J Med"},{"key":"10.1016\/j.semperi.2021.151531_bib0010","article-title":"Finding that babies born at 22 weeks can survive could change abortion debate","author":"Westcott","year":"2015","journal-title":"Newsweek"},{"key":"10.1016\/j.semperi.2021.151531_bib0011","series-title":"Premature Babies May Survive at 22 Weeks if Treated, Study Finds","author":"Belluck","year":"2015"},{"key":"10.1016\/j.semperi.2021.151531_bib0012","doi-asserted-by":"crossref","first-page":"e7976","DOI":"10.1136\/bmj.e7976","article-title":"Short term outcomes after extreme preterm birth in England: comparison of two birth cohorts in 1995 and 2006 (the EPICure studies)","volume":"345","author":"Costeloe","year":"2012","journal-title":"BMJ"},{"issue":"6","key":"10.1016\/j.semperi.2021.151531_bib0013","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1053\/j.semperi.2013.06.027","article-title":"Ethical issues in periviable birth","volume":"37","author":"Chervenak","year":"2013","journal-title":"Semin Perinatol"},{"issue":"8","key":"10.1016\/j.semperi.2021.151531_bib0014","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1080\/15265161.2017.1340988","article-title":"Saving or creating: which are we doing when we resuscitate extremely preterm infants?","volume":"17","author":"Reider","year":"2017","journal-title":"Am J Bioeth"},{"issue":"2","key":"10.1016\/j.semperi.2021.151531_bib0015","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1016\/j.clp.2017.01.006","article-title":"Personalized decision making: practical recommendations for antenatal counseling for fragile neonates","volume":"44","author":"Haward","year":"2017","journal-title":"Clin Perinatol"},{"issue":"3","key":"10.1016\/j.semperi.2021.151531_bib0016","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1111\/bioe.12428","article-title":"Fragile lives with fragile rights: Justice for babies born at the limit of viability","volume":"32","author":"Hendriks","year":"2018","journal-title":"Bioethics"},{"issue":"10","key":"10.1016\/j.semperi.2021.151531_bib0017","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1001\/jama.2015.10244","article-title":"Trends in care practices, morbidity, and mortality of extremely preterm neonates, 1993-2012","volume":"314","author":"Stoll","year":"2015","journal-title":"JAMA"},{"issue":"1","key":"10.1016\/j.semperi.2021.151531_bib0018","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.siny.2017.10.004","article-title":"Rationing potentially inappropriate treatment in newborn intensive care in developed countries","volume":"23","author":"Wilkinson","year":"2018","journal-title":"Semin Fetal Neonatal Med"},{"issue":"7","key":"10.1016\/j.semperi.2021.151531_bib0019","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1111\/apa.12633","article-title":"The ethics and practice of neonatal resuscitation at the limits of viability: an international perspective","volume":"103","author":"Fanaroff","year":"2014","journal-title":"Acta Paediatr"},{"issue":"6","key":"10.1016\/j.semperi.2021.151531_bib0020","doi-asserted-by":"crossref","first-page":"F470","DOI":"10.1136\/archdischild-2017-313332","article-title":"Variation of practice and poor outcomes for extremely low gestation births: ordained before birth?","volume":"102","author":"Janvier","year":"2017","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"10.1016\/j.semperi.2021.151531_bib0021","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.clp.2017.01.009","article-title":"Survival of infants born at periviable gestational ages","volume":"44","author":"Patel","year":"2017","journal-title":"Clin Perinatol"},{"issue":"9","key":"10.1016\/j.semperi.2021.151531_bib0022","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1056\/NEJM198108273050904","article-title":"Evaluation of neonatal-intensive-care program","volume":"305","author":"Sinclair","year":"1981","journal-title":"N Engl J Med"},{"issue":"222","key":"10.1016\/j.semperi.2021.151531_bib0023","first-page":"330","article-title":"Economic evaluation of neonatal intensive care of very-low-birth-weight infants","volume":"308","author":"Boyle","year":"1983","journal-title":"N Engl J Med"},{"issue":"3","key":"10.1016\/j.semperi.2021.151531_bib0024","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1215\/03616878-27-3-441","article-title":"The use of expensive health technologies in the era of managed care: the remarkable case of neonatal intensive care","volume":"27","author":"Friedman","year":"2002","journal-title":"J Health Polit Policy Law"},{"issue":"3","key":"10.1016\/j.semperi.2021.151531_bib0025","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1542\/peds.101.3.344","article-title":"Restricting access to neonatal intensive care: effect on mortality and economic savings","volume":"101","author":"Stolz","year":"1998","journal-title":"Pediatrics"},{"issue":"1","key":"10.1016\/j.semperi.2021.151531_bib0026","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1542\/peds.2005-0484","article-title":"Costs of newborn care in California: a population- based study","volume":"117","author":"Schmitt","year":"2006","journal-title":"Pediatrics"},{"issue":"3","key":"10.1016\/j.semperi.2021.151531_bib0027","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1542\/peds.113.3.510","article-title":"Evaluation of neonatal intensive care for extremely low birth weight infants in Victoria over two decades: II. Efficiency","volume":"113","author":"Doyle","year":"2004","journal-title":"Pediatrics"},{"issue":"1","key":"10.1016\/j.semperi.2021.151531_bib0028","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1164\/ajrccm.156.1.9510103","article-title":"Epidemiology and rationing at the extremes of life","volume":"156","author":"Lantos","year":"1997","journal-title":"Am J Respir Crit Care Med"},{"key":"10.1016\/j.semperi.2021.151531_bib0029","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.jpeds.2017.05.056","article-title":"Outcomes of preterm infants following discussions about withdrawal or withholding of life support","volume":"190","author":"James","year":"2017","journal-title":"J Pediatr"},{"key":"#cr-split#-10.1016\/j.semperi.2021.151531_bib0030.1","unstructured":"D.M. Cutler, E. Meara. The technology of birth: is it worth it? National Bureau of Economic Research Working Paper No 7390, October 1999. Frontiers in Health Policy Research, 2000"},{"key":"#cr-split#-10.1016\/j.semperi.2021.151531_bib0030.2","unstructured":"3: 33-68. http:\/\/www.nber.org\/papers\/w7390. Accessed Nov 22, 2021."},{"issue":"1","key":"10.1016\/j.semperi.2021.151531_bib0031","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/S0167-6296(96)00507-3","article-title":"Accounting for future costs in medical cost-effectiveness analysis","volume":"16","author":"Meltzer","year":"1997","journal-title":"J Health Econ"},{"issue":"12","key":"10.1016\/j.semperi.2021.151531_bib0032","doi-asserted-by":"crossref","first-page":"933","DOI":"10.7326\/0003-4819-132-12-200006200-00002","article-title":"The cost-effectiveness of sildenafil","volume":"132","author":"Smith","year":"2000","journal-title":"Ann Intern Med"},{"issue":"3","key":"10.1016\/j.semperi.2021.151531_bib0033","doi-asserted-by":"crossref","first-page":"F208","DOI":"10.1136\/archdischild-2017-312748","article-title":"Survival of very preterm infants admitted to neonatal care in England 2008-2014: time trends and regional variation","volume":"103","author":"Santhakumaran","year":"2018","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"10.1016\/j.semperi.2021.151531_bib0034","series-title":"Moral Status: Obligations to Persons and Other Living Things","author":"Warren","year":"1997"},{"key":"10.1016\/j.semperi.2021.151531_bib0035","series-title":"Should the Baby live? The Problem of Handicapped Infants","author":"Kuhse","year":"1985"},{"issue":"5","key":"10.1016\/j.semperi.2021.151531_bib0036","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1016\/j.gerinurse.2007.11.001","article-title":"Levels of personhood: a model for dementia care","volume":"29","author":"Buron","year":"2008","journal-title":"Geriatr Nurs"}],"container-title":["Seminars in Perinatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0146000521001452?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0146000521001452?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2023,11,12]],"date-time":"2023-11-12T11:27:10Z","timestamp":1699788430000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0146000521001452"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3]]},"references-count":37,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,3]]}},"alternative-id":["S0146000521001452"],"URL":"https:\/\/doi.org\/10.1016\/j.semperi.2021.151531","relation":{},"ISSN":["0146-0005"],"issn-type":[{"value":"0146-0005","type":"print"}],"subject":[],"published":{"date-parts":[[2022,3]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Ethical implications of the shifting borderline of viability","name":"articletitle","label":"Article Title"},{"value":"Seminars in Perinatology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.semperi.2021.151531","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2021 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}],"article-number":"151531"}}