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| '''Baby K''' (October 13, 1992 - 1995) was an ] baby who became the center of a major court case and a debate among ]. | |||
| '''Baby K''' was born in an ] state on ], ], at ] in ]. That is, she was born missing almost all of her ]. In fact, all that remained of her brain was the ], that primitive part of the brain responsible (in part) for ] and ], such as the control of ], the ] and ] . | |||
| == |
== History == | ||
| {{Cleanup-section|date=May 2007}} | |||
| Despite being aware of the baby's condition prior to birth,<sup>]'']</sup> Ms. H., the mother of Baby K., carried the child to term, in spite of medical advice to abort. Motivated by a strong ] conviction that "all life is precious" and that ] alone should decide how long the baby would live,<ref>Flannery, E. (1995) One advocate’s viewpoint: conflict and tensions in the Baby K case. Journal of Law, Medicine & Ethics, 23: 7-12</ref> she remained adamant that Baby K. be kept alive as long as possible. The hospital’s position was that such care would be ].{{Fact|date=November 2007}} | |||
| Baby K was born at ] in ]. At the time of her birth, she was missing most of her brain, including the cortex; all that remained was the], that portion of the brain responsible for ] and regulatory functions, such as the control of ], the ] and ].<ref>Ruling in Virginia, ''The New York Times'', Feb 12, 1994</ref>. The baby's mother was aparently aware of her condition prior to her birth, but chose to carry the child to term because of "a firm Christian faith that all life should be protected.<ref>Greenhouse, Linda. Hospital Appeals Ruling on Treating Baby with Most of Brain Gone, ''The New York Times'', Sept. 24, 1993</ref> She believed that God alone should decide how long the baby would live.<ref>Flannery, E. (1995) One advocate’s viewpoint: conflict and tensions in the Baby K case. Journal of Law, Medicine & Ethics, 23: 7-12</ref> The hospital's viewpoint was that care provided to the baby would be ].<ref>Greenhouse, Linda. Hospital Appeals Ruling on Treating Baby with Most of Brain Gone, ''The New York Times'', Sept. 24, 1993</ref> | |||
| Ms. H. wanted the hospital to continue with advanced supportive care (primarily ventilatory support), despite the generally accepted medical practice that anencephaly is not curable or treatable, and that maintained life support would be both futile and wasteful.{{Fact|date=November 2007}} Fairfax Hospital doctors advised a ] condition for the child. The mother refused the DNR. Baby K. was left on ] support for 6 weeks while Fairfax searched for another hospital to transfer her to, but all area hospitals claimed they had no room{{Fact|date=February 2007}} (which is believed to be not entirely true; that in actuality no other hospital wanted to take over the ] expectations and legal issues surrounding the child).{{Fact|date=February 2007}} | |||
| After the baby |
The baby's mother wanted the hospital to continue with advanced supportive care (primarily ventilatory support), despite the generally accepted medical practice that anencephaly is not curable or treatable. <ref>Greenhouse, Linda. Court Order to Treat Baby With Partial Brain Prompts Debate on Costs and Ethics, ''The New York Times'' Feb. 20 1994</ref> However, Fairfax Hospital doctors strongly advised a ] order for the child, which the mother refused. Baby K remained on ] support for 6 weeks while Fairfax searched for another hospital to which to transfer, but no other hospital was willing to accept Baby K. After the baby was weaned off constant ventilator support, the mother agreed to move the child to a nursing facility, but the baby returned to the hospital many times for respiratory problems. | ||
| ⚫ | When Baby K. was admitted to the hospital at sixth months of age for severe respiratory problems, the hospital filed a legal motion to appoint a guardian for the child's care and sough a court order that the hospital did not need to provide any services beyond ] care. At trial, several experts testified that providing ventilator support to an anencephalic infant went beyond the accepted standard of medical care.<ref>Matter of Baby K. 16 F.3d 590 (] ])</ref>. In contrast, the baby's mother argued her case on the grounds of religious freedom and the ]. In a controversial ruling, the ] decided that the hospital caring for Baby K must put her on a mechanical ventilator whenever she had trouble breathing. The court interpreted the ] (EMTALA) to require continued ventilation for the infant. The wording of this act requires that patients who present with a ] must get "such treatment as may be required to stabilize the medical condition" before the patient is transferred to another facility. The court refused to take a ] or ] position on the issue, insisting that it was only interpreting the laws as they existed. As a result of the decision, Baby K was kept alive much longer than most anencephalic babies.<ref>Greenhouse, Linda. Hospital Appeals Ruling on Treating Baby with Most of Brain Gone, ''The New York Times'', Sept. 24, 1993</ref> The dissenting judge in the case argued that the court should have used the condition anencephaly as the basis of the case, not the recurring subsidiary symptoms of respiratory distress. As the irreversibility of anencephaly is highly accepted in the medical community, he argued that the decision to continue (futile) care only resulted in irresponsible use of medical resources and prolonged suffering.<ref>Matter of Baby K. 16 F.3d 590 (] ])</ref>. | ||
| At 6 months old, Baby K. was admitted to the hospital for severe respiratory problems. The hospital filed a legal motion to appoint a guardian for the child's care, and to declare that the hospital did not need to provide any services beyond ] care. | |||
| ⚫ | ==Significance of Baby K. case== | ||
| ⚫ | |||
| ⚫ | The case of Baby K. is of particular importance to the field of ] because of the rich variety of issues it raises: the definition of death, the nature of ], the concept of medical ], and many issues relating to the allocation of scarce resources. | ||
| Some commentators{{Who|date=November 2007}} on the decision argue that it effectively turned doctors into mere "instruments of technology"{{Fact|date=November 2007}}, and took away a doctor's prerogative to make responsible, ] medical decisions.{{Fact|date=November 2007}} | |||
| Some commentators, including Arthur Kohrman and Jacob Appel, have argued that the ruling effectively undermined the right of physicians to make sound medical decisions. | |||
| ⚫ | == |
||
| ⚫ | The case of Baby K. is of particular importance to |
||
| The dissenting judge in the legal case argued that the court should have used the condition anencephaly as the basis of the case, not the recurring subsidiary symptoms of respiratory distress. As the irreversibility of anencephaly is highly accepted in the medical community, he argued that the decision to continue (futile) care only resulted in irresponsible use of medical resources{{Fact|date=November 2007}}, and prolonged suffering.{{Fact|date=November 2007}} | |||
| {{EthicsCases}} | {{EthicsCases}} | ||
Revision as of 01:28, 27 December 2008
Baby K (October 13, 1992 - 1995) was an anencephalic baby who became the center of a major court case and a debate among bioethicists.
History
Baby K was born at Fairfax Hospital in Virginia. At the time of her birth, she was missing most of her brain, including the cortex; all that remained was thebrainstem, that portion of the brain responsible for autonomic and regulatory functions, such as the control of respiration, the heartbeat and blood pressure.. The baby's mother was aparently aware of her condition prior to her birth, but chose to carry the child to term because of "a firm Christian faith that all life should be protected. She believed that God alone should decide how long the baby would live. The hospital's viewpoint was that care provided to the baby would be futile.
The baby's mother wanted the hospital to continue with advanced supportive care (primarily ventilatory support), despite the generally accepted medical practice that anencephaly is not curable or treatable. However, Fairfax Hospital doctors strongly advised a Do Not Resuscitate order for the child, which the mother refused. Baby K remained on ventilator support for 6 weeks while Fairfax searched for another hospital to which to transfer, but no other hospital was willing to accept Baby K. After the baby was weaned off constant ventilator support, the mother agreed to move the child to a nursing facility, but the baby returned to the hospital many times for respiratory problems.
When Baby K. was admitted to the hospital at sixth months of age for severe respiratory problems, the hospital filed a legal motion to appoint a guardian for the child's care and sough a court order that the hospital did not need to provide any services beyond palliative care. At trial, several experts testified that providing ventilator support to an anencephalic infant went beyond the accepted standard of medical care.. In contrast, the baby's mother argued her case on the grounds of religious freedom and the sanctity of life. In a controversial ruling, the United States District Court for the Eastern District of Virginia decided that the hospital caring for Baby K must put her on a mechanical ventilator whenever she had trouble breathing. The court interpreted the Emergency Medical Treatment and Active Labor Act (EMTALA) to require continued ventilation for the infant. The wording of this act requires that patients who present with a medical emergency must get "such treatment as may be required to stabilize the medical condition" before the patient is transferred to another facility. The court refused to take a moral or ethical position on the issue, insisting that it was only interpreting the laws as they existed. As a result of the decision, Baby K was kept alive much longer than most anencephalic babies. The dissenting judge in the case argued that the court should have used the condition anencephaly as the basis of the case, not the recurring subsidiary symptoms of respiratory distress. As the irreversibility of anencephaly is highly accepted in the medical community, he argued that the decision to continue (futile) care only resulted in irresponsible use of medical resources and prolonged suffering..
Significance of Baby K. case
The case of Baby K. is of particular importance to the field of bioethics because of the rich variety of issues it raises: the definition of death, the nature of personhood, the concept of medical futility, and many issues relating to the allocation of scarce resources.
Some commentators, including Arthur Kohrman and Jacob Appel, have argued that the ruling effectively undermined the right of physicians to make sound medical decisions.
References
- Ruling in Virginia, The New York Times, Feb 12, 1994
- Greenhouse, Linda. Hospital Appeals Ruling on Treating Baby with Most of Brain Gone, The New York Times, Sept. 24, 1993
- Flannery, E. (1995) One advocate’s viewpoint: conflict and tensions in the Baby K case. Journal of Law, Medicine & Ethics, 23: 7-12
- Greenhouse, Linda. Hospital Appeals Ruling on Treating Baby with Most of Brain Gone, The New York Times, Sept. 24, 1993
- Greenhouse, Linda. Court Order to Treat Baby With Partial Brain Prompts Debate on Costs and Ethics, The New York Times Feb. 20 1994
- Matter of Baby K. 16 F.3d 590 (4th Cir. 1994)
- Greenhouse, Linda. Hospital Appeals Ruling on Treating Baby with Most of Brain Gone, The New York Times, Sept. 24, 1993
- Matter of Baby K. 16 F.3d 590 (4th Cir. 1994)
External links
- Futile Care and the Neonate: In the Matter of Baby K at Medscape
- Anencephalic Babies page at Kennedy Institute of Ethics
- Stress and Distress in Pediatric Nurses: The Hidden Tragedy of Baby K. by Ronald M. Perkin
- Thaddeus Mason Pope, Involuntary Passive Euthanasia in U.S. Courts: Reassessing the Judicial Treatment of Medical Futility Cases, 9 MARQUETTE ELDER'S ADVISOR 229-68 (2008)
- FIGO