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 Vol. 10 No. 2, February 2009
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NeoReviews Vol.10 No.2 2009 e65
© 2009 American Academy of Pediatrics

Hot Debate About a Cool Therapy

John D. Lantos, MD*
William L. Meadow, MD, PhD{dagger}

* *Professor of Pediatrics, Associate Director, MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, Ill.; John B. Francis Chair of Bioethics, Center for Practical Bioethics, Kansas City, Mo
{dagger} Professor of Pediatrics, Section Chief, Neonatology, Assistant Director, MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, Ill

The status of hypothermia as a treatment for perinatal asphyxia remains controversial. This review examines recent studies and professional opinions about whether this treatment should be considered "experimental" or "standard" and places the debate in the context of other debates about innovative neonatal therapies, including the use of oxygen, antenatal steroids, extracorporeal membrane oxygenation, and pressors. These controversies are examples of a fundamental epistemological question in the philosophy of science, namely, how much evidence is necessary to prove or disprove any hypothesis. Finally, we discuss the implications of the current level of knowledge about hypothermia for further research and clinical practice.


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