Baby Doe Law
Encyclopedia
The Baby Doe Law or Baby Doe Amendment is the name of an amendment to the Child Abuse Law passed in 1984 in the United States
that sets forth specific criteria and guidelines for the treatment of seriously ill and/or disabled newborns. The law is controversial in that it dictates what must be done for a child, regardless of the wishes of the parents.
whose parents declined surgery to fix esophageal atresia
with tracheoesophageal fistula
, leading to the baby's death. The Surgeon General of the U.S. at the time of this incident, C. Everett Koop
, argued the child was denied treatment (and food and water) not because the treatment was risky but rather because the child was mentally retarded. Koop commented publicly that he disagreed with such withholding of treatment. In his decades as a pediatric surgeon, Dr Koop had repaired hundreds of such defects, with a continually improving rate of success. By 1982, success was nearly certain if the surgery was performed.
A similar situation in 1983 involving a "Baby Jane Doe
" again brought the issue of withholding treatment for newborns with disabilities to public attention. In this case, Baby Jane Doe was born with spina bifida
, an abnormally small head, and hydrocephaly. Dr. Koop advocated medical treatment despite the severity of the condition and the limited outcomes that would result.
Koop's efforts to educate Congress about this issue ultimately led to the Baby Doe Amendment (U.S.C.A. TITLE 42, CHAPTER 67, Sec. 5106a). On October 9, 1984, the amendment extended the laws defining child abuse to include the withholding of fluids, food, and medically indicated treatment from disabled children. The law went into effect on June 1, 1985. For information about this, see: Kathryn Moss (1987)
THE "BABY DOE" LEGISLATION ITS RISE AND FALL
Policy Studies Journal 15 (4), 629–651.
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
that sets forth specific criteria and guidelines for the treatment of seriously ill and/or disabled newborns. The law is controversial in that it dictates what must be done for a child, regardless of the wishes of the parents.
Details of the law
The Baby Doe Law mandates that states receiving federal money for child abuse programs develop procedures to report medical neglect, which the law defines as the withholding of treatment unless a baby is irreversibly comatose or the treatment is "virtually futile" in terms of the newborn's survival. Opinions about a child's "quality of life" are not valid reasons for withholding medical care.Background of the law
The law came about as a result of several widely publicized cases involving the deaths of handicapped newborns. They died from being withheld medical treatment,starved and not getting any water. The primary case was a 1982 incident involving "Baby Doe", a Bloomington, Indiana baby with Down syndromeDown syndrome
Down syndrome, or Down's syndrome, trisomy 21, is a chromosomal condition caused by the presence of all or part of an extra 21st chromosome. It is named after John Langdon Down, the British physician who described the syndrome in 1866. The condition was clinically described earlier in the 19th...
whose parents declined surgery to fix esophageal atresia
Esophageal atresia
Esophageal atresia is a congenital medical condition which affects the alimentary tract. It causes the esophagus to end in a blind-ended pouch rather than connecting normally to the stomach. It comprises a variety of congenital anatomic defects that are caused by an abnormal embryological...
with tracheoesophageal fistula
Tracheoesophageal fistula
A tracheoesophageal fistula is an abnormal connection between the esophagus and the trachea...
, leading to the baby's death. The Surgeon General of the U.S. at the time of this incident, C. Everett Koop
C. Everett Koop
Charles Everett Koop, MD is an American pediatric surgeon and public health administrator. He was a vice admiral in the Public Health Service Commissioned Corps, and served as thirteenth Surgeon General of the United States under President Ronald Reagan from 1982 to 1989.-Early years:Koop was born...
, argued the child was denied treatment (and food and water) not because the treatment was risky but rather because the child was mentally retarded. Koop commented publicly that he disagreed with such withholding of treatment. In his decades as a pediatric surgeon, Dr Koop had repaired hundreds of such defects, with a continually improving rate of success. By 1982, success was nearly certain if the surgery was performed.
A similar situation in 1983 involving a "Baby Jane Doe
Baby Jane Doe
Baby Jane Doe is the pseudonym given to a baby born in 1983 with severe birth defects that required surgery to correct. Her birth and the circumstances surrounding the surgery aroused considerable controversy and resulted in the Baby Doe Law establishing requirements for decision making for...
" again brought the issue of withholding treatment for newborns with disabilities to public attention. In this case, Baby Jane Doe was born with spina bifida
Spina bifida
Spina bifida is a developmental congenital disorder caused by the incomplete closing of the embryonic neural tube. Some vertebrae overlying the spinal cord are not fully formed and remain unfused and open. If the opening is large enough, this allows a portion of the spinal cord to protrude through...
, an abnormally small head, and hydrocephaly. Dr. Koop advocated medical treatment despite the severity of the condition and the limited outcomes that would result.
Koop's efforts to educate Congress about this issue ultimately led to the Baby Doe Amendment (U.S.C.A. TITLE 42, CHAPTER 67, Sec. 5106a). On October 9, 1984, the amendment extended the laws defining child abuse to include the withholding of fluids, food, and medically indicated treatment from disabled children. The law went into effect on June 1, 1985. For information about this, see: Kathryn Moss (1987)
THE "BABY DOE" LEGISLATION ITS RISE AND FALL
Policy Studies Journal 15 (4), 629–651.
Changes in the regulations over time
In order to enforce the regulations laid out in the Baby Doe Law, telephone hot lines were set up around the country and the federal government encouraged anonymous reporting of alleged child abuse (specifically, the withholding of medical care to seriously ill newborns). The hotlines were discontinued, however, as they resulted in the frequent intrusion of federal investigators into hospitals, often without warrant or without finding actual abuse.Actual text of the law
The following text is found under the eligibility requirements for federal funding in U.S.C.A. TITLE 42, CHAPTER 67, Sec. 5106a. Grants to States for child abuse and neglect prevention and treatment programs: an assurance that the State has in place procedures for responding to the reporting of medical neglect (including instances of withholding of medically indicated treatment from disabled infants with life-threatening conditions), procedures or programs, or both (within the State child protective services system), to provide for---
- (i) coordination and consultation with individuals designated by and within appropriate health-care facilities;
- (ii) prompt notification by individuals designated by and within appropriate health-care facilities of cases of suspected medical neglect (including instances of withholding of medically indicated treatment from disabled infants with life-threatening conditions); and
- (iii) authority, under State law, for the State child protective services system to pursue any legal remedies, including the authority to initiate legal proceedings in a court of competent jurisdiction, as may be necessary to prevent the withholding of medically indicated treatment from disabled infants with life threatening conditions;
See also
- Born-Alive Infants Protection ActBorn-Alive Infants Protection ActThe Born-Alive Infants Protection Act of 2002 is an Act of Congress. It extends legal protection to an infant born alive after a failed attempt at induced abortion. It was signed by President George W...
- Meltdown (Steve Taylor album)Meltdown (Steve Taylor album)Meltdown is the title of the second album by singer/songwriter Steve Taylor.This album was listed at #18 in the book, CCM Presents: The 100 Greatest Albums in Christian Music.-Side one:# "Meltdown " – 4:26...
Christian artist Steve Taylor wrote a song in 1984 in response to the Baby Doe incidents, entitled "Baby Doe."