solved

Questions 1, 2, and 3
9-10Baby Doe
Unlike the informed Non consent of autonomous adults or the substituted-judgment cases involving those who are irreversibly incompetent to make decisions are those situations involving withholding or withdrawing care from infants. No decisions are more filled with anguish for all involved, parents and health care providers alike. In the spring of 1982, an infant known as Baby Doe was born with an esophageal-tracheal fistula and trisomy 21, a form of mental retardation known commonly as Down syndrome. The esophageal-tracheal fistula needed immediate surgery if the infant was to be fed. The decision of whether to do the surgery would not have been questioned for a normal infant. The physicians split in their recommendations as to whether to provide the surgery in this case, the parents with court concurrence elected to refuse the surgery on behalf of their child, and the infant died. The parents based their decision on their view that it would not be in their son’s best interest to survive, since he would always be severely retarded.
In March 1983, in response to this case and others like it, the U.S. Department of Health and Human Services issued an Interim Final Rule, which directed that all health care facilities dealing with infants less than one year of age and who received federal funding prominently display an antidiscrimination notice protecting these infants. The notice provided a “handicapped infant hot-line” for those who might witness cases where infants were receiving less than “customary medical care.” Anyone in the nursery could then call and complain about care, and the federal government would send representatives to investigate the allegations. The fear of “Baby Doe squads” descending on the health care facility and involving themselves in what had previously been a rather private parent-physician arena of decision making had a serious chilling effect on deliberations having to do with infant care. The force of the notices was to place a potential conflict between the law and the moral obligations of the health care providers. Legal duties in and of themselves do not establish moral duties and vice versa.
As with most other important issues, responsible forces lined up on both sides. Opposing the regulations were groups such as the American Academy of Pediatrics and the American Medical Association. In support were groups such as the American Association of Retarded Citizens, who felt that the decision to provide care should be neutral in respect to handicap. In other words, if a “normal infant” would have received the surgery, then infants with handicaps should also. Of the almost 4 million infants born each year, approximately 10 percent are born prematurely or with major birth defects. Modern surgery and neonatal care has been rather miraculous; however, many of these infants still face life severely handicapped.
In 1985, the Department of Health and Human Services provided a final draft of the Baby Doe regulations regarding the treatment of handicapped children. If there is available treatment for the condition, it must be provided. The regulations consider the withholding of medical care for these handicapped infants to be reglect. The regulations provided three exceptions:
When the infant is chronically and irreversibly comatose.
When treatment would only prolong dying.
When the treatment would be futile, or inhumane.
With this ruling, the federal government was out of the Baby Doe business, and parents and physicians once again could wrestle with these problems somewhat out of the public eye.
Regardless of who the primary decision makers are, the ethical problems remain. Whereas parents have a right to privacy and to be left alone in their decisions in regard to their children, this is not an absolute right and does not extend to child abuse. What is the child’s best interest in these cases?
If the infant’s mental and physical handicaps are overwhelming, it would be inhumane to provide life-extending care and to salvage the infant to a life whose only awareness is that of pain and suffering. On the other hand, to refuse care to a child on the whimsy of being dissatisfied with a particular model is equally distasteful. The right choice for these babies is easy to determine at the extremes, but it becomes a true problem when deciding for the infants—in which it is not clear—as to what constitutes their best interest. Perhaps these are cases that are best served by basing the judgments on the quality-of-life issue or personhood.
Translated into the language of personhood, an infant who has no present or future potential for self-awareness or relationships can be said to have no interests at all. It then becomes incomprehensible to provide life-extending care based on the child’s best interests, as it makes no difference to the child whether the equipment is maintained for five minutes or five years.
Legal Case StudyA Question of Futility: Baby K, 832 F. Supp. 1022 (E.D. Va. 1993)
In this case, the infant girl was born with the congenital malformation anencephaly that left only her brain-stem functioning. The limited function allowed for a continuation of breathing but the infant was permanently unconscious; she could not see or interact with her environment. At birth the physicians and institutional ethics committee had advised the mother that the ventilator had been put in place awaiting a firm diagnosis. But given the child’s prognosis its continued use was futile, and it should be removed. The mother disagreed, and several other hospitals were contacted to see if the baby could be transferred. All refused, and finally the child was transferred to a nursing home.
On several occasions the child was readmitted to the hospital through the emergency room and given ventilator support. The hospital attempted to resist these admissions, but the court held they must provide the services. The court determined that to refuse care to the infant would be in violation of the Emergency Medical Treatment and Active Labor Act (EMTALA), the Americans with Disabilities ACT (ADA), and parental decision-making rights as guaranteed by the Fourteenth Amendment to the Constitution.
1. How would you resolve this dilemma?
2. How would you define futility? How does the child fit in your definition?
3. Review the EMTALA statute and explain why the courts used it to cover this case.

******CLICK ORDER NOW BELOW AND OUR WRITERS WILL WRITE AN ANSWER TO THIS ASSIGNMENT OR ANY OTHER ASSIGNMENT, DISCUSSION, ESSAY, HOMEWORK OR QUESTION YOU MAY HAVE. OUR PAPERS ARE PLAGIARISM FREE*******."