The findings presented in an accompanying paper by Menzies, Parkin, and Hey regarding the survival rates and quality of life of babies with severe spina bifida (Lancet 1985 Nov 2; 2(8462): 993-995) prompt the Working Group to reevaluate the ethical guidelines supporting selective treatment proposed in their 1975 report, "Ethics of Selective Treatment of Spina Bifida" (Lancet 1975 Jan 11; 1(7898): 85-88). Although Menzies, et al., report that survival rates are higher than previously expected and that in most cases the children's and parents' lives appear not to be excessively burdensome, the Working Group contends that there "continues to be ethical justification for selective treatment" of such newborns. Since medical, psychological, and social considerations now seem to be "more complex and less clearcut," the Group emphasizes that judgments regarding treatment should be made on a case-by-case basis.