1. Impaired Infants

2. Dealing with Defective Children Baby Doe/Baby Owens Jehovah's Witnesses' children Two issues: a)Do parents have the right to refuse life- saving/life sustaining therapies for their children? Assume: Children are incompetent by reason of age or ability to make decisions for themselves Baby Owens is Downs' Syndrome, will be retarded but the level of retardation is unknown at birth Jehovah's Witnesses believe that blood transfusions are prohibited by biblical teaching

3. Dealing with Defective Children b)If parents refuse, is there an obligation for anyone else to intervene, e.g. health care professionals, the courts, the state, etc.? How serious should the consequences be in order to justify intervention?

4. Dealing with Defective Children An Overlapping Issue: What level or quality of life justifies withholding or withdrawing life-saving therapy? 1)Down's Syndrome? 2)Profound retardation? 3)Loss of sight, hearing, or both? 4)Paralysis? 5)Pain/distress, e.g. Lesch-Nyhans? 6)Continuous ventilation? 7)Nutrition and hydration? 8)Anencephaly?

5. Dealing with Defective Children Who defines what is an acceptable quality of life? 1)Medical consensus? 2)"Best interests" of the child from the child's point of view (inner view)? 3)"Best interests" of the child from a social point of view (outer view), burdens to others? 4)Futility? 5)Parent/s?

6. Born anencephalic (similar to PVS but without cerebral structure Needs nutrition and hydration Needs ventilation Baby K Hospital, physicians, ethics committee, and father view continued treatment as "futile" and "inhumane" Mother wants to continue treatment, says that all human life (including her daughter's) has a value and that God will work a miracle is that is his will Does the mother have the right to request continued treatment if medical opinion is that the treatment is futile?

7. Baby K Further complicating factor: Baby K has frequent respiratory crises and needs to be brought to the ER for resuscitation The Federal Emergency Medical Treatment Act requires that ERs must treat anyone with an emergency condition (sometimes called the "anti- dumpin" law) to the point of stability Thus, the hospital is required to treat Baby K when brought to the ER

8. Baby K The hospital appeals that Baby K is an exception to the law Court rules: "Absent of finding of neglect or abuse" parents have the right to make decisions about medical treatment for their children and, when parents disagree, the court should support the parent who decides "in favor of life."