The Nuffield Council on Bioethics, which considers ethical questions raised by advances in medical research, has recommended that babies born at or before 22 weeks should not be resuscitated or given intensive care.
The parents' wishes should be taken into account for those born after 23 weeks. However doctors warned that no two babies born at 22 or 23 weeks would be the same.
The report has been released after two years of research.
Professor Margaret Brazier of the Nuffield Council on Bioethics says "We don't think it is always right to put a baby through the stress and pain of invasive treatment if the baby is unlikely to get any better and death is inevitable"
The report also gives guidance on how parents should resolve arguments with doctors over the fate of their babies. It comes against a backdrop of medical advances which have been able to sustain the lives of very premature babies. However, research shows that many of these babies do not live very long, or go on to develop severe disability.
Despite advances in modern medicine, it is not always obvious to doctors which babies will survive and thrive.
Professor Margaret Brazier, who chaired the committee that produced the guidelines, said: "Natural instincts are to try to save all babies, even if the baby's chances of survival are low.
"However, we don't think it is always right to put a baby through the stress and pain of invasive treatment if the baby is unlikely to get any better and death is inevitable."
As well as resource implications for the NHS, the inquiry also looked at longer-term support for families.
RECOMMENDATIONS FROM THE REPORT.
Born before 22 weeks: No intensive care
22-23 weeks: No intensive care, unless parents request it after a thorough discussion of the risks and doctors agree
23-24 weeks: Parents, after a thorough discussion with the healthcare team, should have the final say
24-25 weeks: Give intensive care, unless the parents and the doctors agree there is no hope of survival, or the level of suffering is too high
Above 25 weeks: Intensive care as standard
Bliss, the premature baby charity, is campaigning for one-to-one neonatal intensive care, and for decisions to made based on clinical reasoning, and not financial constraints. The charity said the UK had the highest rate of low birth weight babies in Western Europe.
About 300 babies are born in the UK each year at 23 weeks. They have a 17% survival rate, compared with 50% for those born at 25 weeks. Figures suggest that no baby survives at 21 weeks, while only 1% survive to leave hospital at 22 weeks.
Andy Cole, Bliss chief executive, said: "While only a small percentage of infants in the UK are born at 24 weeks or less, it is essential that every baby should be treated as an individual and given the best and most appropriate care at the point of life.
"We strongly endorse the recommendation that assessment of care for the most vulnerable infants needs to be a joint decision between parents and clinicians."
Earlier this month the Royal College of Obstetricians and Gynaecologists said it wanted a discussion over whether "deliberate intervention" to cause death in severely disabled babies should be legalised.
The Nuffield Council on Bioethics was established in 1991 to examine ethical questions raised by advances in biological and medical research.
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