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Periviable Birth - The Ethical Conundrum. When delivery is anticipated near the limit of viability, both the family and the caregiver are faced with many complex and ethically challenging decisions. It must be remembered that the decisions that are made are going to impact the entire life of the baby and the family. Such decisions should be based on the best available evidence about the prognosis for the infant. If the chance of mortality and serious morbidity for an infant is high (but not too high), parental discretion around provision of life-sustaining treatment is appropriate. In this article, we discuss issues on survival and outcomes of extremely premature infants, and the available guidelines.