Courtwright et al.1 report that the diagnosis of ‘lethal’ conditions prenatally leads to care that is less intense, lower cost and of similar survival benefit when compared with postnatally diagnosed cases. Based on these results, the authors conclude that ‘highly aggressive interventions did not prolong survival in these cases and should not be offered.’ Based on such a definitive assessment one would assume that despite aggressive efforts to support infants after a lethal diagnosis, there was no significant prolongation of life. The authors do not report data that would allow such a determination to be made. Given the lack of such data, the phenomenon of the self-fulfilling prophecy (SFP) is a likely explanation for the authors' findings.