Richard Dur is the volunteer Executive Director of Prolife Alberta and an award-winning political consultant with experience on campaigns across Canada.The room was too quiet. Delivery rooms are supposed to be noisy.Monitors beeping. Nurses calling out numbers. Someone saying, “He’s here!”Instead, there was a pause, the kind that stretches longer than it should, as a baby smaller than anyone in the room had ever seen was lifted into the light. He fit easily in two hands. His chest fluttered. His skin was almost translucent. Someone whispered a weight: ounces, not pounds.There was a moment — a real, human moment — where the room had to decide what this child was.A patient worth fighting for? Or a life already written off by policy.In one hospital, the answer was to try. Tubes. Ventilation. Monitors. Incubator. Hours turning into days. Days into months. And eventually, a child going home.Not a miracle. Medicine. A decision to treat instead of withdraw.That moment, the moment between try and don’t try, is where public policy often quietly decides..And in Alberta, the policies governing that moment deserve far more scrutiny than they currently receive.Alberta prides itself on its independence, prosperity, freedom, and refusal to follow trends simply because others do. It reflects a province built by people willing to push forward where others hesitate.But across North America, including in Ontario, care teams are pushing boundaries once thought immovable. Hospitals provide care at gestational ages that, only a decade ago, were dismissed as impossible. At institutions like the University of Iowa Health Care, clinicians are already treating some babies born just after 21 weeks when parents request it. Not because survival is guaranteed. But because it is no longer impossible.That distinction matters.Medicine advances when physicians refuse to let yesterday’s assumptions dictate today’s care. Ventilation techniques improve. Monitoring becomes more precise. Drug protocols evolve. And most importantly, survival curves shift. Parents are increasingly treated as central decision-makers when outcomes are uncertain. They are given honest information: survival may be unlikely. Disability risk may be high. The road will be long. But there is hope.And then they are asked: Do you want us to try?That model also reflects modern medical ethics: informed consent and shared decision-making between doctors and families..Twenty-six weeks was once considered futile. Then 24. Then 23. Then 22. Now, careful case-by-case treatment is being explored even earlier. Except, it seems, in Alberta. In Alberta, the governing framework for managing extremely premature delivery is found within guidelines used by Alberta Health Services.Specifically, guideline HCS-183-01 addresses clinical management around extremely early preterm birth. Section 6.5 of the document contains language that deserves public scrutiny:“The survival of infants born before or at 22 6/7 completed weeks of gestation remains uncommon. A non-interventional approach is recommended.” Put plainly: babies born younger than 23 weeks gestation are left to die.No one is arguing that every extremely premature infant will survive. But when trying can mean the difference between life and death, policies that discourage or disallow it must meet the highest possible standard of justification. Surely such policies should err on the side of life. .How care frameworks are written and applied within systems like AHS should matter deeply to all of us: when policy pre-decides non-intervention based on gestational thresholds alone, it risks determining whether care is even attempted — placing bureaucracy above ethics, medicine, and family.Somewhere, perhaps even today, another delivery room will go quiet.Another child will arrive earlier than anyone hoped or expected. Another team will face that moment: try or don’t try.Hopefully, for the sake of that infant and her parents, that child is born in a system like those operating in Ontario — where parents have a meaningful say in the level of care their child will receive — instead of Alberta, where policy will still default to “a non-interventional approach.”For a province that prides itself on setting standards, not lagging behind them, we should be asking whether this reflects who we believe we really are.Richard Dur is the volunteer Executive Director of Prolife Alberta and an award-winning political consultant with experience on campaigns across Canada.Learn more about Alberta’s “born alive” policy gap and how to support reform at LeftToDie.ca
