To the Editor.—

William A. Silverman died (December 16, 2004) before his letter to the editor, “Russian Roulette in the Delivery Room,” was published in the January 2005 issue of Pediatrics. When he wrote that letter in September 2004, he asked me to write some comments when it was published, as he had done in the past. This letter was written in response to that request.

Dr Silverman, one of the world's leading neonatologists for over 50 years, was also one of the specialty's most severe critics. He frequently wrote about much-heralded treatments and procedures, often ones he himself had once adopted, but that were subsequently found to be deleterious to these infants. Such experiences led him to become an ardent supporter of documented and scientifically sound clinical trials before adoption of often well-intended, innovative interventions. Thus, his concern about the use of high-technology procedures and medications...

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