New 'Baby Doe' rules could lead to intrusion on parents' rights
Compromise federal legislation was supposed to hush the controversy over life support for severely handicapped infants, sparked by the so-called ''Baby Doe'' case that made headlines over the past two years. Unfortunately, the newly enacted amendment to the Child Abuse Prevention Act will probably only perpetuate the debate.
We can take as a given that child abuse is bad. Strong precautions are essential to detect and check it. But the new law is in some respects an example of Big Brother meddling where he is least equipped to help. Even more troubling is the continuing trend of government to intrude in areas where private citizens should be allowed to find their own solutions.
The new law is a congressional response to the serious problem of mistreatment of children. The issue has been highly orchestrated in the news media - with focus on the most flagrant and shocking cases. And, although the problem is being addressed on the state and local levels by both the public and private sectors, pressure has been put on federal lawmakers to ''do something.'' And in this election year, Congress has found it difficult to ignore the public prodding.
Understandable. But the new amendment goes far beyond the needed protection of children from battering and other demeaning treatment. It provides for governmental oversight of care of infants with extreme physical or mental limitations. And it redefines ''abuse'' and ''neglect'' in terms of ''withholding of medically indicated treatment from disabled infants with life-threatening conditions.''
Fortunately, the law does not automatically impose harsh criminal penalties on medical doctors, parents, or others who don't meet its provisions, as earlier proposed legislation and Reagan administration guidelines would have done. Nor are physicians required to make heroic efforts to save a baby's life. Instead they are told to rely on ''reasonable medical judgment.''
Nonetheless, two problems are obvious at the outset: (1) Lawsuits will almost certainly result to determine, among other things, what is and is not ''reasonable medical judgment.'' Some judges have already indicated they feel unequipped to make this type of decision; (2) there is no provision for religious exemption, which would allow those who want to rely on means other than medicine to do so. This could lead to an invasion of parental rights and responsibilities and conflict with the religious guarantees in the US Constitution.
If the courts don't keep this controversy simmering, so-called right-to-life groups are likely to stoke the fire. In addition to their staunch support of anti-abortion measures, these interests have been active in supporting prosecution of parents who have decided against surgery for seriously deformed infants. And they have supported (the now-invalidated) government rules that forbade ''discrimination'' against handicapped infants. Ironically, many of those who favor maximum public regulation of abortion and mandating of life-support medical systems have generally opposed government interference in private family matters. On these two issues, however, their position is quite different.
The so-called ''Baby Doe'' debate grew from a 1982 Indiana case in which parents felt the humane course was to deny nourishment to an infant born with severe physical defects. The hospital challenged this decision in the courts. Legal proceedings were suspended when the child died.
The case sparked a national debate, however. And in 1983, the federal Department of Health and Human Services (HHS) issued initial regulations requiring every US hospital or maternity facility that receives federal assistance to post a notice stating that ''discrimination against handicapped infants'' is a crime. A telephone ''hot line'' was also set up to facilitate reporting of violations.
The American Medical Association and hospital groups protested that their professional integrity was being challenged and that the government was tampering in areas in which it had no right to do so. These groups went to court and won - invalidating the HHS rules.
During the past year, Congress has been studying the issue.
At the same time the HHS was framing new regulations. These have scrapped the hot line and softened the impact of governmental intrusion into the delivery room by requiring, instead, that hospitals set up infant-care review committees to make the delicate ethical decisions that might involve the withholding of life-sustaining treatment.
Those who opposed additional legislation hoped that the retooled administrative regulations would obviate the need for it. But public pressures and political considerations apparently prevailed.
A recent editorial in the New York Times concludes:
''What the mothers and fathers of severely handicapped infants need is the best possible medical advice and the counseling of clergy and community and social workers - the members of a good hospital review board, not state and federal intruders. No Congress should want to be responsible for so terrible an entry into the American home.''
Points well taken! The ''Baby Doe'' law implies that parents are not equipped to provide adequate care for their own children. And, conversely, that somehow the government and the courts are better qualified to make decisions to ensure the well-being of infants. The latter is not only a questionable assumption. It's an affront to a democratic system that cherishes individual and family rights.