baby doe

Baby Doe Law

The Baby Doe Law or Baby Doe Amendment is the name of an amendment to the Child Abuse Law passed in 1984 in the United States that sets forth specific criteria and guidelines for the treatment of seriously ill and/or disabled newborns. The law is controversial in that it dictates what must be done for a child, regardless of the wishes of the parents.

Details of the law

The Baby Doe Law mandates that states receiving federal money for child abuse programs develop procedures to report medical neglect, which the law defines as the withholding of treatment unless a baby is irreversibly comatose or the treatment is "virtually futile" in terms of the newborn's survival. Concerns about a child's quality of life, which are often the primary factors in deciding to withhold medical treatment from premature infants, are no longer seen as valid reasons for withholding medical care.

Background of the law

The law came about as a result of several widely publicized cases involving the deaths of handicapped newborns that resulted from withheld medical treatment. The primary case was a 1982 incident involving "Baby Doe" a Bloomington, Indiana baby with Down syndrome whose parents declined surgery to fix tracheo-esophageal fistula, leading to the baby's death. The Surgeon General of the U.S. at the time of this incident, C. Everett Koop, argued the child was denied treatment not because the treatment was risky but rather because the child was mentally retarded. Koop commented publicly that he disagreed with such withholding of treatment.

A similar situation in 1983 involving a "Baby Jane Doe" again brought the issue of withholding treatment for newborns with disabilities to public attention. In this case, Baby Jane Doe was born with spina bifida, an abnormally small head, and hydrocephaly. Dr. Koop advocated medical treatment despite the severity of the condition and the limited outcomes that would result.

Koop's efforts to educate Congress about this issue ultimately led to the Baby Doe Amendment (U.S.C.A. TITLE 42, CHAPTER 67, Sec. 5106a). On October 9, 1984, the amendment extended the laws defining child abuse to include the withholding of fluids, food, and medically indicated treatment from disabled children. The law went into effect on June 1, 1985, but was only in place for a few years before it was overturned in Federal Court. For information about this, see: Kathryn Moss (1987) THE "BABY DOE" LEGISLATION ITS RISE AND FALL Policy Studies Journal 15 (4), 629–651.

Changes in the regulations over time

In order to enforce the regulations laid out in the Baby Doe Law, telephone hot lines were set up around the country and the federal government encouraged anonymous reporting of alleged child abuse (specifically, the withholding of medical care to seriously ill newborns). The hotlines were discontinued, however, as they resulted in the frequent intrusion of federal investigators into hospitals, often without warrant or without finding actual abuse.

Actual text of the law

The following text is found under the eligibility requirements for federal funding in U.S.C.A. TITLE 42, CHAPTER 67, Sec. 5106a. Grants to States for child abuse and neglect prevention and treatment programs:
(B) an assurance that the State has in place procedures for responding to the reporting of medical neglect (including instances of withholding of medically indicated treatment from disabled infants with life-threatening conditions), procedures or programs, or both (within the State child protective services system), to provide for--
(i) coordination and consultation with individuals designated by and within appropriate health-care facilities;
(ii) prompt notification by individuals designated by and within appropriate health-care facilities of cases of suspected medical neglect (including instances of withholding of medically indicated treatment from disabled infants with life-threatening conditions); and
(iii) authority, under State law, for the State child protective services system to pursue any legal remedies, including the authority to initiate legal proceedings in a court of competent jurisdiction, as may be necessary to prevent the withholding of medically indicated treatment from disabled infants with life threatening conditions;



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