Baby case tests rights of parents

He suggests a trial period for extremely premature babies, known as micropreemies, such as 10 days on a ventilator. That way doctors could get a better idea of how the child will do and what problems it may face in the future. But that route is also problematic, admits Mr. Annas, because most doctors will feel compelled to continue with treatment once they've started.

"Doctors are dedicated to saving lives and, if given the choice, will go all out for everybody," he says. But "if it's a judgment call, then it should be the parents' call because they are the ones who have to live with the child."

John Robertson, bioethicist at the University of Texas in Austin and a consultant for the defense, disagrees. "Parents do not have the right to deny treatment necessary to keep children alive."

Maybe they should have such a right in certain cases, he says, but only after birth when doctors know how serious the problems are. "No one knew how serious Sidney Miller's disabilities would be. You simply can't predict that before birth."

A full-term pregnancy is 40 weeks. healthy micropreemies have been as young as 23 weeks - considered the edge of viability.

In an era when such successes remain rare, doctors are the ones most qualified to make difficult decisions in such cases, says Sheldon Korones, a professor of pediatrics and director of the Newborn Center at the University of Tennessee in Memphis. "If the supreme court rules in [the Millers'] favor, it will mean that doctors cannot apply their judgment in similar situations," he says.

Still, other experts say parents have strong claims as well."I think that it is really inappropriate to override the wishes of the parents, particularly with children like this," says Ellen Wright Clayton, a pediatrics expert at Vanderbilt University in Nashville. "They are the ones who have to care for the child."

Many hospitals, she says, believe they are bound by the federal Child Abuse and Treatment Act of 1984, or Baby Doe law, in cases like this. It required that states develop procedures to protect disabled infants with life-threatening conditions and to report instances of parental neglect, such as withholding treatment.

But that law was not designed with premature babies in mind, says Dr. Clayton, nor did it give doctors the authority to treat a baby without a court order.

According to the Millers' attorney, the hospital was required to get such an order before overriding the couple's decision. Lawyers for the hospital replied that the doctors were legally and morally obligated to save Sidney.

In 1998, a Texas jury found Columbia/HCA, the nation's largest for-profit hospital chain and owner of the Woman's Hospital of Texas, negligent and ordered it to pay $43 million to cover the cost of Sidney's care for life. An appellate court overturned that decision.

Now the Millers await a decision from the state's highest court. "Maybe Sidney was given to us because God knew that we'd care for her," says Mr. Miller. "That's all we're trying to do."

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