Chapter 9 :   Severely Impaired Newborns, Futility and Infanticide

Section 1. Case Presentation
This section was organized, prepared and written by Mark Riddagh (SCCC, 2006) using Ronald Munson's Intervention and Reflection as a guide.
Baby K: Anencephalic Infants and the Responsibility of Hospitals

1993, Falls Church, VA Fairfax Hospital

Baby K, as she came to be known, was born with a severe neurological condition known as anencephaly. In affect, she was born with both cerebral hemispheres missing from her brain, which means that her greatest potential would be shy of ever producing a single, fundamental thought. Her mother, insisted that Fairfax Hospital provide Baby K whatever treatment was necessary to keep her alive as long as possible, as most anencephaly cases failed to survive for more than a few hours, days or weeks at best. Fairfax, in Falls Church, VA provided the standard treatment for Baby K’s condition and obliged her mother’s insistence for aggressive respiratory treatment when needed. The cause of death can commonly be linked to the fact that the single brain stem cannot support normal respiratory functioning. The hospital staff did what they could to keep Baby K and her mother as happy as possible and awaited the infant’s unavoidable death.

But Baby K proved to be a survivor. At sixteen months she was stable at an extended care facility that provided her constant attention and total care. The hospital was still obliged to provide the respiratory treatment needed for her survival, at her mother’s continual insistence, although the physicians believed that further respiratory intervention would be futile. Eventually, Fairfax sought a ruling from the federal district court that would allow them to refuse the aggressive respiratory treatment that kept Baby K alive.

Although their case was overturned in court, Fairfax appealed the decision at the U.S. Court of Appeals. Again their position that Baby K’s quality of life was not sufficient to mandate the treatments she was receiving, was not supported due to the 1986 Federal Emergency Medical Treatment and Active Labor Act. This law required hospitals to provide the type of treatment that Baby K needed as long as she needed it.

Although the law was not originally intended for cases like Baby K’s, it was instead passed to keep private hospitals from "dumping" emergency cases without insurance to public facilities, the courts perceived that they could not support the hospitals request to deny life saving treatment to Baby K, despite the fact that she was incapable of anything more than existing in a void of nothingness.

Baby Owens: The Rights of a Baby with Down Syndrome

1976, Midwestern Hospital

Baby Owens was born at 11:30 pm to Dr. Owens and her husband, Philip at Midwestern Hospital. The proud parents didn’t remain proud very long as their first meeting with the child showed that something was terribly wrong. The baby’s misshapen head and aloof look in those strangely shaped eyes had all the earmarks of Down syndrome and neither Dr. Owen nor her husband were prepared to accept a baby of such shortcomings into their home, their family or their lives. They verbally announced their feelings to the staff that had taken care of Dr. Owen during the birth and any attempt to console them was futile. Their minds were made up.

To add insult to injury, Baby Owens was hiding a deeper secret. She was born with a sealed patch in her small intestine, also known as duodenal atresia. Although the condition is lethal if left untreated, as the baby would not be able to eat, a relatively minor surgical intervention could correct the problem and Baby Owens would grow into a normal healthy child, at least as normal and healthy as a Down baby can be. In all honesty, the physicians had no way to determine the extent of Baby Owens’ mental retardation, but it made no difference to the Owens’s, severe or mild, their baby would be ultimately retarded and that was one condition they just could not accept.

Dr. Owens informed Dr. Ziner, her attending physician, that she and her husband would not authorize the surgery needed to save Baby Owens’ life. According to Dr. Owens, "It wouldn’t be fair to the other children to raise them with a mongoloid. It would take all of our time, and we wouldn’t be able to give David, Sean and Melinda the love and attention they need." (Munson, Intervention and Reflection – 144) Despite Dr. Ziner’s objections, Dr. Owens remained firm in her and her husband’s decision to allow Baby Owen to die of starvation by denying her the life-saving surgery.

The hospital’s legal and medical representative got together to discuss their position on the matter. What action, if any, should they take to prevent the death of an otherwise physically health child? In previous matters when a parent’s religious belief conflicted with a necessary surgery on a child, the hospital had received court orders mandating the surgery, regardless of the parents’ wishes. But was this case different? Was the fact that the baby was mentally handicapped a spin that would allow her death? The hospital decided that they had no reason to force the parents to authorize the operation and subsequently, be forced to take home a baby that they didn’t want. The official position of Midwestern Hospital was that they could not perform an operation on an infant without parental consent.

Twelve days later, Baby Owens died of starvation in an isolated room away from the other patients. Although many on the staff were appalled by the hospital’s position to allow the death of an otherwise healthy baby, they were not allowed to intervene in the baby’s slow, lingering death. The most they were permitted was to apply drops of water her lips and throat in an attempt to ease her suffering.

Some Severe Abnormalities

Infanticide- Left to die    Leaving breathing infants to die. The video is political and biased but it does describe some actual cases of infants out of the womb and left to die.   http://www.youtube.com/watch?v=BYRpIf2F9NA  

 

Why Was There The Need For The Born Alive Infants Protection Act?

Some images courtesy of Nucleus Communications, Inc.. Some news video clips courtesy of Fox News, CNN. Other images, video clips and text either from Fair Use of the public domain. Produced by Secret of the Rosary Films. Part 2 currently in production.

Obama And Infanticide - Part 1 - 45 Minutes / Documentary Video / Why Was There The Need For The Born Alive Infants Protection Act?

Obama And Infanticide - Part 2 - 23 Minutes  
http://www.youtube.com/watch?v=IrhWq4nXtdk&feature=related
 
/ Documentary Video / The Evidence Against Obama / Illinois Senate Bills SB-1093, SB-1094, SB-1095 / Regular Session Illinois Senate Transcript With Commentary And Analysis

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CASE:  Baby Jane Doe by Patrick Fabian (SCCC 2012)

Baby Jane Doe was born in St. Charles Hospital on Long Island and was transferred to the University Hospital at Stony brook due to her several major birth defects. Which included spina bifoda, hydrocephalus, a damaged kidney and microcephaly. A surgeon at Stony Brook recommended immediate surgery however, a pediatric neurologist told the parents that the baby would die soon without surgery or if she had surgery, she would be paralyzed, retarded and possibly have continuous infections of her bladder and bowels. The parents decided not to have surgery. A lawyer filed a case to force treatment for baby Jane.  

Describing the case: 

http://embryo.asu.edu/view/embryo:128384

http://www.nytimes.com/1983/10/21/nyregion/judge-blocks-an-operation-for-li-baby.html

http://openjurist.org/729/f2d/144/united-states-v-university-hospital-state-university-of-new-york-at-stony-brook

http://www.people.com/people/archive/article/0,,20087928,00.html 

Ethical Positions: 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3241062/

http://www.mnddc.org/honoring-choices/cnnReports/Moral_and_Ethical_Issues4-Baby-Doe-Kappel.pdf

http://www.ascensionhealth.org/index.php?option=com_content&view=article&id=235&Itemid=173

http://www.sris.org/prog/samples/cnmc/doctors/Ethic00.pdf

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Case Baby dies after hospital removes breathing tube  by Melissa Williams-Mitchell (SCCC 2012)

Sun Hudson, a six months infant was disconnected from life support after a Harris County Probate Court Judge reaffirmed an earlier decision to lift restrictions preventing Texas Children’s hospital from ending life sustaining treatment for child. Hudson was born with thanatophoric dysplasia, a condition characterized by tiny lungs and rib cage too small to support life. The baby’s mother was against the decision and filed the suit claiming that the baby just need more time to grow. The ethics committee decided it was unethical and inhumane to continue mechanical ventilation of the infant. The mother was given 10 days to find another hospital if she was not satisfied with the hospital’s decision to remove the breathing tube but no other hospital was willing to take the child and in the end the breathing tube was removed.

a. Materials concerning the case located on the internet:

http://www.chron.com/news/houston-texas/article/Baby-dies-after-hospital-removes-breathing-tube-1926032.php

http://www.foxnews.com/story/0,2933,151386,00.html

http://library.cqpress.com/cqresearcher/document.php?id=cqresrre2005051300

http://www.childrensmercy.org/content/uploadedFiles/RIGHT%20TO%20DIE.pdf

 b. Viewpoints on the case by analyst, ethicists, commentators:

http://virtualmentor.ama-assn.org/2007/05/msoc1-0705.html

http://digitalarchive.gsu.edu/cgi/viewcontent.cgi?article=2393&context=gsulr&sei-redir=1&referer=http%3A%2F%2Fwww.google.com%2Fsearch%3Fq%3Dethics%2Bwith%2Bsun%2Bhudson%26hl%3Den%26safe%3Dactive%26gbv%3D2%26prmd%3Divnsb%26ei%3DRtXxT9TnNIfH0QHp4438Ag%26start%3D30%26sa%3DN#search=%22ethics%20sun%20hudson%22

http://www.anslab.iastate.edu/Class/AnS536w/18%20Prematurity/7211401a.pdf

http://www.csmonitor.com/2005/0228/p11s02-lire.html

 

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Case Dismissed in Slaying of Deformed Baby    Case Study by Richard Godwin (SCCC 2012) 

 Daniel McKay slammed his infant son to the delivery room floor moments after the boy was born with a cleft palate, a harelip and webbed fingers. His attorneys contended that the child's terrible condition had driven McKay into a state of temporary insanity. The state argued that the deformities did not excuse the killing. "Baby McKay did not deserve the fate he met," Raymond Garza, an assistant state's attorney, argued at one point in the proceedings. "He was not such a horrible creature that his life deserved to be snuffed out." After the two hung juries, the defense moved in November, 1987, for dismissal of the charges. Gierach granted the motion in January, 1988, but the state appealed. The appeals court returned the case to Gierach on a technicality.  The judge's final dismissal on Friday left McKay, who practices veterinary medicine in Beecher, "absolutely ecstatic," his attorney said. 

Describing case:

http://articles.latimes.com/1990-07-14/news/mn-252_1_baby-mckay

http://dailyranger.com/story.php?story_id=607&headline=Judge-says-murder-case-in-child-death-can-proceed

http://articles.chicagotribune.com/1985-02-15/news/8501090610_1_mistrial-unanimous-verdict-two-jurors

http://badvetdaily.blogspot.com/2008/04/illinois-veterinarian-daniel-mckay.html 

Ethical Reasons:

http://jonrappoport.wordpress.com/2012/03/06/the-ethics-of-killing-babies/

http://www.infowars.com/the-ethics-of-killing-babies-with-investigative-reporter-jon-rappoprt/

http://wdtprs.com/blog/2012/02/ethics-groups-says-babies-are-not-actual-persons-and-killing-them-is-fine/

http://www.bbc.co.uk/ethics/abortion/medical/infanticide_1.shtml

http://www.australiandoctor.com.au/news/ethical-to-kill-newborns-academics-say

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CASE:  Indian father accused of killing baby 'for being a girl'  by  Michelle Jack (SCCC 2012)

Reshma Banu, a nineteen year old, sits and stares at a video of her baby girl, Afreen. This video is the only thing she has left to remember her baby girl when she was alive and well.  Police say that she was killed by her father due to her sex. Afreen was three months old when she was admitted to the hospital and later died. The mother, Reshma, explained how her husband was angered that she had a girl and gave her an ultimatum.  The husband explained that girls are expensive and if she does not figure out a way to pay for her than she must kill her.  She did not believe her husband was serious, but he was. Her baby girl is now dead and her husband under arrest for female infanticide.

Articles Describing case:

http://www.cnn.com/2012/06/14/world/asia/india-female-infanticide/index.html

http://www.democraticunderground.com/12554923

http://www.gendercide.org/case_infanticide.html/

http://www.thenational.ae/news/world/south-asia/baby-girls-killing-reveals-indias-crisis-of-gender-bias

Articles with Ethical Position:

http://www.bbc.co.uk/ethics/abortion/medical/infanticide_1.shtml

http://www.domesticviolenceservices.com/female-infanticide.html

http://www.issuesinmedicalethics.org/034ed061.html

http://aidindia.org/aipsn/health/feticide.html

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Keli Lane Case INFANTICIDE    by Caitlin Taylor (SCCC 2012)

This is a well known infanticide case that took place in Australia. In 2010 Keli Lane was found guilty of murdering her daughter Tegan. She had a history of concealing pregnancies and births as she did with her first child (Tegan was her second). It took years for a social worker to realize that this baby was missing and to alert authorities. Lane had claimed that she gave Tegan to her father. After an investigation into the child’s disappearance, Keli was charged with the murder of her daughter. She was sentenced to 13 years and 5 months of non-paroled jail time.

Short Summary of Keli Lane Case http://guides.sl.nsw.gov.au/content.php?pid=242811&sid=2189501

(3 Part Article on Different Aspects of Keli Lane Case)

Print Copy of Judges Decision
http://www.austlii.edu.au/au/cases/nsw/NSWSC/2011/289.html

Taxi Driver Claims he Saw Tegan Alive
http://www.news.com.au/national/taxi-driver-saw-keli-lanes-baby-tegan-alive/story-e6frfkvr-1226041140710

Safe-Haven Laws in Australia  to Prevent Future Deaths

http://www.f4e.com.au/blog/2010/12/18/baby-safe-haven-laws-victoria-moves-to-protect-newborns/

Experts Discuss Infanticide

Australian Legislation and Infanticide (legal perspective and facts)

http://www.lawlink.nsw.gov.au/lrc.nsf/pages/R83CHP3

After Birth Abortion “why should the baby live?” Controversial article- authors refer to the practice as “after birth abortion”

http://jme.bmj.com/content/early/2012/03/01/medethics-2011-100411.full

Psychiatric Information (post partum psychosis and infanticide)

http://ajp.psychiatryonline.org/article.aspx?articleid=100698

Infanticide for Handicapped Infants (sometimes is a metaphysical dispute)

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1375559/?page=1 

Extra Information

Infanticide Statistics

http://bjs.ojp.usdoj.gov/content/homicide/children.cfm

Rabbi’s Perspective on Infanticide

http://www.huffingtonpost.com/rabbi-adam-jacobs/infanticide-is-the-new-abortion_b_1318997.html 

Case INFANTICIDE     The Andrea Yates Case by Jennifer O’Connor (2012)

Andrea Yates, 36 year old wife and mother, killed all five of her children ranging in age from 6 months to seven years, on June 20, 2001 by drowning them one by one in a bathtub and then placing their little bodies in bed.  This horrendous act of infanticide shocked the nation and has been blamed on depression, religious fanaticism, and psychosis.  If Andrea Yates suffered from post-partum psychosis, those she sought help from let her down by allowing her to care for five children alone while in an extremely fragile state. Women are often treated with such disregard that even when screaming for help, society ignores them. Infanticide needs to be looked at from the views of the society it occurs in.  China and India practice gender infanticide.  Poverty stricken third world countries condone infanticide.  America considers infanticide a crime.  However, much more needs to be done world-wide towards protecting the innocent lives and preventing the discrimination against both mother and child.

The following articles describe the Andrea Yates case:

http://crime.about.com/od/current/p/andreayates.htm

http://www.trutv.com/library/crime/notorious_murders/women/andrea_yates/index.html

http://www.time.com/time/nation/article/0,8599,218445,00.html

http://www.lancet.com/journals/lancet/article/PIIS0140-6736(06)69789-4/fulltext

The following articles discuss if mental illness or post-partum psychosis is to blame:

http://pregnancy.about.com/cs/postpartumdepress/a/aa062101a.htm

http://serendip.brynmawr.edu/exchange/node/1717

http://articles.cnn.com/2001-06-28/justice/postpartum.defense_1_insanity-defense-postpartum-depression-texas-woman?_s=PM:LAW

The following professional articles discuss ethical issues of maternal infanticide:

http://ajp.psychiatryonline.org/article.aspx?articleID=177022

http://www.psychologytoday.com/articles/200212/moms-who-kill

http://www.psychologytoday.com/blog/the-new-brain/200912/baby-blues-search-beyond-neurons

http://scholarship.law.duke.edu/cgi/viewcontent.cgi?article=1073&context=djglp

http://www.ncbi.nlm.nih.gov/pubmed/15337641

The following article discusses the contrasting views surrounding infanticide:

http://www.ncbi.nlm.nih.gov/pubmed/15868392

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© Copyright Philip A. Pecorino 2002. All Rights reserved.

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