Academic journal article The Hastings Center Report

Let's Take Baby Doe to Alaska

Academic journal article The Hastings Center Report

Let's Take Baby Doe to Alaska

Article excerpt

Let's Take Baby Doe to Alaska

Many commentators have criticized the "Baby Doe regulations" issued by DHHS in 1985 as embodying a "medical indications policy," that leaves inadequate room for moral considerations, such as parental values, in decisionmaking about treatment for seriously ill or impaired newborns. A recent report of the U.S. Commission on Civil Rights, Medical Discrimination against Children with Disabilities, presupposes this narrow interpretation, asserting that prognosis is the only relevant treatment consideration and decrying consideration of a child's best interest by parents, the health care team, or ethics committees. The report charges that "discriminatory denial of medical treatment...has not dramatically changed since the implementation of the Child Abuse Amendments of 1984..." (pp. 148-49).

There are several ironies here. First, the Civil Rights Commission drew this conclusion without ever gathering any data about changes in the incidence of "medical neglect." Even William Allen, the chair of the commission, remarked that for a report costing half a million dollars, this reflected "a certain kind of research incontinence" (154-55).

In addition, the regulations have probably served to "protect" treatment decisions from the influence of parental values, but with substantial overtreatment being the result. For example, only 52 percent of surveyed neonatologists felt certain that the regulations allow termination of treatment for a 550-gram premature infant with less than a 5 percent chance of survival (Kopelman, NEJM 318(11):677-88). Over a quarter of pediatricians in Massachusetts would (mis)interpret the guidelines to require maximum therapy for anencephalic infants (Todres, Pediatrics 81(5):643-49).

The most tragic irony, however, is that while the government has expended enormous energy to protect severely impaired infants from the influence of "secular" concerns such as the best interest of the child, it has done almost nothing to insure that infants and children with acute and manifestly treatable medical needs receive therapy despite their parents' religious beliefs. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.