Respond to each part of the prompt: As Dr. Atlas described, infant mortality is a complex metric that is dependent on many factors including policies and practices and standards of care that can vary widely among nations. In order to accurately establish the ranking of infant mortality in the United States against that of other nations, it would be necessary to assess the performance of each nation according to reasonably consistent criteria. How likely are other nations to adopt the United States' "model" (our definition of a live birth; linkage of birth and death certificates; standard of care, including aggressive resuscitation practices, etc.)? What would be the likely "net effect" on the healthcare systems of other nations, and their rankings, if they were to do so? . Alternatively, what if the United States could improve its ranking by adopting the policies and practices and standards of care of higher ranked nations as are described by Dr. Atlas in Chapter 3? What would be the "net effect of such policies and practices, especially the standard of care for preterm infants, on American society? . Would the policies and practices of better ranked nations be morally and ethically acceptable in the United States? (I am personally troubled by a standard of care that would withhold resuscitation for certain preterm newborns despite "signs of life.") . If the policies and practices of better ranked nations, at least with respect to infant mortality, would NOT be morally and ethically acceptable in the United States, then does there remain any value in such a ranking? Respond to each part of the prompt: As Dr. Atlas described, infant mortality is a complex metric that is dependent on many factors including policies and practices and standards of care that can vary widely among nations. In order to accurately establish the ranking of infant mortality in the United States against that of other nations, it would be necessary to assess the performance of each nation according to reasonably consistent criteria. How likely are other nations to adopt the United States' "model" (our definition of a live birth; linkage of birth and death certificates; standard of care, including aggressive resuscitation practices, etc.)? What would be the likely "net effect" on the healthcare systems of other nations, and their rankings, if they were to do so? . Alternatively, what if the United States could improve its ranking by adopting the policies and practices and standards of care of higher ranked nations as are described by Dr. Atlas in Chapter 3? What would be the "net effect of such policies and practices, especially the standard of care for preterm infants, on American society? . Would the policies and practices of better ranked nations be morally and ethically acceptable in the United States? (I am personally troubled by a standard of care that would withhold resuscitation for certain preterm newborns despite "signs of life.") . If the policies and practices of better ranked nations, at least with respect to infant mortality, would NOT be morally and ethically acceptable in the United States, then does there remain any value in such a ranking
