The circumstances of 88 deaths in the Neonatal Department, Rigshospitalet Copenhagen, were reviewed with special emphasis on the clinical background for, and parental attitude to withholding life-sustaining treatment. We recorded whether these considerations appeared in the patient's medical record, the type of treatment withheld and the use of opioids. No infant died under ongoing maximal treatment. Fourteen infants were judged to have died with "almost certainty" (gr A), 48 infants were judged to have died with great probability (gr B) and 26 infants were judged to have had a considerable chance of survival (gr C). Opioids were used more often in the terminal course of treatment in group C as opposed to group B. Parental attitudes and clinical background were not fully described in the medical record for many patients. The decision to withhold life sustaining treatment in the severely ill neonate was made to avoid prolonged futile suffering, or survival with very severe handicaps.