Seriously Ill Children - Infant Mortality, Birth Defects, Low Birthweight And Prematurity, Who Makes Medical Decisions For Infants?
What greater pain could mortals have than this;
To see their children dead before their eyes?
—Euripides
To a parent, the death of a child is an affront to the proper order of things. Children are supposed to outlive their parents, not the other way around. And when a child comes into the world irreparably ill, what is a parent to do—insist on continuous medical intervention, hoping against hope that a miracle happens, or let nature take its course and allow the newborn to die? When a five-year-old child has painful, life-threatening disabilities, the parent is faced with a similar agonizing decision. That decision is the parent's to make, preferably with the advice of a sensitive physician. But what if the ailing child is an adolescent who refuses further treatment for a terminal illness? Does a parent honor that wish?
Additional Topics
Since 1960 the infant mortality rate in the United States has declined 74 percent—from 26 deaths per 1,000 live births in 1960 to 6.8 deaths per 1,000 live births in 2001. (Table 5.1 shows the decline from 1983 to 2001, while Table 5.2 shows figures for 2001 and preliminary figures for 2002.) Advances in neonatology (the medical subspecialty concerned with the care of newborns, especially t…
The March of Dimes Birth Defects Foundation, a national volunteer organization that seeks to improve infant health by preventing birth defects and mortality, reports that a baby is born with a birth defect every three and one-half minutes, and one in five infant deaths is caused by birth defects. In March 1998 the Birth Defects Prevention Act (PL 105-168) was passed, "expressing the sense o…
Infants who weigh less than 2,500 grams (or 5 pounds, 8 ounces) at birth are considered to be of low birthweight. Those born weighing less than 1,500 grams (3 pounds, 4 ounces) have very low birthweight. Low birthweight may result from various causes, including premature birth, poor maternal nutrition, teen pregnancy, drug and alcohol use, smoking, or sexually transmitted diseases. In 2002, 7.8 pe…
In April 1982 an infant with Down's syndrome was born at Bloomington Hospital in Indiana. The infant also had esophageal atresia, an obstruction in the esophagus that prevents the passage of food from the mouth to the stomach. Following their obstetrician's recommendation, the parents decided to forego surgery to repair the baby's esophagus. The baby would be kept pain-free wi…
The American Academy of Pediatrics reports that not much has been written about life-sustaining treatments as they apply to older children. The courts generally have been lenient in allowing parents to act in the best interests of their children. The courts have been known to let the parents' decisions stand, even when court-appointed guardians disagreed with those decisions. During the 197…
While the government, ethicists, and pro-life advocates debate life-and-death decisions, parents and physicians of ailing children are the ones faced with immediate, difficult, real-life choices. Many factors influence decision making, and each situation is unique. The following two stories illustrate such situations. In 1993 Francisca Rodriguez died of AIDS, which she had contracted from her form…
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