mahowald reading detailed reading summary notes

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Published on 17 May 2011
Mahowald Reading
Decisions regarding disabled newborns
Neonatal intensive care are still comparatively unavailable or inaccessible to the
populations of the less developed nations
Infanticide was at one time practiced in many cultures, including the western
world- infants were not killed outright but were rather left to die either because
they were defective, twins, illegitimate or female
Little distinction between killing and letting die
Indirect infanticide could be the refusal of providing an IV nutrition to an infant
who is incapable of normal digestion
Robert Weir argues that it is sometimes morally justified to terminate an infants
life directly and actively
Patient autonomy is then turned over to the parents who makes decisions on behalf
of their children
Parental rights in the case of infants are generally perceived as primary, requiring
practitioners to respect their decisions even if they involve refusal of life-
prolonging treatment
There is an inevitable connection between very low birth weight babies and
disabled infants
The Doe Babies
Case one: little boy born with down syndrome and esophageal atresia whos
parents refused to allow surgery and prolong his life and he died
After that it was passed that no one could discriminate against the handicapped
Case two: Jane Doe, was born with an open spine, reduced brain size and excess
fluid in the brain and would need surgery to survive but the parents were told she
could be retarded or paralyzed – the parents refused to allow the surgery but it was
brought to the attention of federal authorities who said it violated the statute
prohibiting discrimination against the handicapped
Congress then passed legislation requiring state child protection agencies to
intervene in cases where severely disabled infants are refused ‘medically indicated
treatment’- exceptions to this would be if the infants treatment would be futile and
inhumane or would only prolong dying
Who should decide?
Since newborns are unable of providing informed consent, their parents are
usually the proxies or surrogate decision makers
The right of the parents to act as proxies may be overruled if their decision
opposes their child’s best interests
Ex. If a Jehovahs Witness declines a blood transfusion for their child, the hospital
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