Medicine: The Stormy Legacy of Baby Doe

(2 of 2)

The Government argues that the in former system developed by the hotline has been effective. As of last week, there had been 33 accusations that hospitalized infants were not receiving proper care. In eleven cases, the Government dispatched teams composed of doctors and civil rights investigators. The squads found nothing to criticize on eight visits, but were able to help save the lives of three handicapped infants whose doctors seemed to be unaware of new techniques for treating birth defects.

The pediatricians and allied medical groups argue that the best way to help such afflicted babies is by better educating doctors about medical advances, not by sending in federal watchdogs. Hospitals charge that some of the investigative teams disrupted neonatal clinics. Such disturbances led the A.A.P. to protest that "the Government's 'remedy' is potentially harmful to the very infants it seeks to protect."

As an alternative to direct federal interference under the Baby Doe rule, the pediatricians, the A.H.A. and five other medical groups propose that all hospitals be required to create "infant bioethical review committees" to protect the rights of handicapped newborns. These committees, composed of medical experts, laymen, clergy and lawyers, would be consulted in any decision to forgo treatment.

The groups would also try to resolve any conflict between parents and doctors over how to proceed. Should parents refuse to approve treatment that would clearly benefit their child, the committee could ask state agencies and courts to appoint a guardian.

Such an approach is unacceptable to groups representing the handicapped and right-to-life organizations. "The problem is how to ensure the rights of the handicapped to treatment, when the parents, doctors and the hospital agree not to provide it," says Gary Curran of the American Life Lobby. Another worry is that a bioethics committee could not act quickly enough. Warns Paul Marchand, of the Association for Retarded Citizens: "If these infants are not treated within days, hours, they will die."

The Department of Health and Human Services has reservations about the proposal to create ethical review committees. "The problem is there wouldn't be any enforcement," says John Svahn, who was recently promoted from HHS Under Secretary to Assistant to the President for Policy Development. The department hopes to come to a final judgment in the next few weeks. If the hotline and what some doctors deride as investigative "goon squads" are not eliminated, the medical organizations have threatened to take the Reagan Administration to court again. —By Claudia Wallis. Reported by Anne Constable/Washington and Sheila

Gribben/Chicago