Baby Doe

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There is only one group of people in the United States that are required and forced by law to accept medical treatment. The argument is that this group of people are not rational autonomous individuals and that they are not able to give free and informed consent.

In 1984 Congress amended our laws to mandate that all infants born in the United States receive medical care. No matter how sick or disabled, all newborns must be treated regardless of the wishes of the parents. This law is known as the Baby Doe Law. The law came about as a result of a baby born with Down Syndrome whose parents declined surgery to fix a tracheo-esophageal fistula, leading to the baby's death. The law is intended to protect the rights of the disabled. Prior to 1984 children born with a disability were not given aggressive treatment if their parents chose against it for any reason or if doctors deemed it inappropriate. But did federal law go too far in its effort to ensure that children were not allowed to die simply because they had a disability? Did Congress write a law that was overly restrictive? Concerns about a child's quality of life, which are often the primary factors in deciding to withhold medical treatment from premature infants, were no longer seen as valid reasons for withholding medical care.

I had been a nurse for only a couple of years and in those days the physician was all knowing, all mighty and no one dared question his orders, much less speak to him. When a physician would enter the nurses station the nurses had to stand up and offer him their chair. While making rounds on his patients the charge nurse had to follow behind him carrying all of his charts.

A young pregnant woman, who will be referred to as Susan, was home alone. Her husband was in the military and serving outside of the US. She had been sleeping when she was awakened by a trickling of fluid. She got up and went to the bathroom and was relieved that the fluid was not blood and believed it was only urine. Returning to bed she once again felt a small trickle of fluid leaking. Being afraid, she called a cab to take her to the hospital.

I cannot tell you the year, the season, the real name of the mother or what her face looked like, only that she had dark brown hair. Many of the facts quickly disappeared from my memory. The only memories that have remained with me are those directly related to the birth and death of the tiny baby boy.

When Susan arrived, my co-worker, who will be referred to as Mary, and I put Susan to bed and applied the fetal monitor. The three of us were relieved that the baby’s heart sounded strong and was beating at a normal rate, however she was having some small contractions. The patient reported that she was 22 weeks pregnant but had not had any prenatal care because she and her husband did not own a car.

Susan had tested negative for any leaking of amniotic fluid. Mary sent me to call her obstetrician while she started an IV to bolus her with fluids. The doctor gave me some orders and said to call him if the contractions continued. Returning to the patients room I heard the patient screaming “the baby just came out”! As I rounded the corner into her room she was lying on the bed sobbing, with her hands covering her face. Mary was busy at the end of the bed, she had grabbed a wash basin and shoved it under the covers along with a receiving blanket. Seconds later she carefully and quietly slipped the basin out from underneath the covers and handed it to me and told Susan that the baby was a stillborn boy. Susan cried out loudly and I whispered to my co-worker "shouldn’t we ask if she’d like to see her baby”? “No she replied take the baby to the nursery“.

I took the basin into the nursery, set it down on the counter and put a clean paper liner on the scale and made sure the scale was balanced to zero. I then picked up the little bundle wrapped in the receiving blanket, placed it on the scale and removed the blanket. He...
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