Withholding treatment from Baby Doe: from discrimination to child abuse

Area of Science:

• Medical Ethics
• Healthcare Policy
• Neonatal Care

Background:

• Debates on withholding treatment from severely impaired newborns have involved multiple governmental bodies and ethical commissions.
• Past approaches often relied on rigid medical imperatives, which have been criticized for oversimplification.

Purpose of the Study:

• To analyze the evolution of responses to withholding treatment in severely impaired newborns.
• To evaluate the shift from medical imperatives to "best interest" criteria.
• To assess a new legislative compromise principle in neonatal care ethics.

Main Methods:

• Review of administrative and legislative responses from the Reagan and Carter administrations.
• Analysis of ethical commission reports and congressional legislation concerning child abuse and neonatal treatment.
• Examination of the procedural and substantive changes in decision-making criteria.

Main Results:

• Three distinct responses emerged from the Department of Health and Human Services, the President's Commission on Ethical Problems, and subsequent legislation.
• The transition from strict medical imperatives to the "best interest" standard represented a limited advancement.
• A novel legislative compromise has been introduced, acknowledging both moral and medical complexities.

Conclusions:

• The "best interest" standard for neonatal treatment decisions is ambiguous.
• A new legislative compromise offers a practical, albeit imperfect, approach to complex ethical and medical issues in neonatal care.
• Balancing moral considerations with medical realities is crucial in neonatal treatment decisions.