Seriously Ill Children - Infant Mortality, Birth Defects, Low Birth Weight 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?
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Since 1960 the infant mortality rate in the United States has declined 73%—from twenty-six deaths per one thousand live births in 1960 to seven deaths per one thousand live births in 2002, according to the Centers for Disease Control and Prevention (CDC). Table 5.1 shows the decline from 1983 to 2002, while Table 5.2 shows figures for 2002 and preliminary figures for 2003. The data in these…
The March of Dimes Birth Defects Foundation, a national volunteer organization that seeks to improve infant health by preventing birth defects and lowering infant mortality rates, reported in its online quick references and fact sheets on birth defects (http://www.marchofdimes.com/pnhec/4439_1206.asp) that about 120,000 babies are born annually in the United States with birth defects—a rate…
Infants who weigh less than twenty-five hundred grams (or five pounds, eight ounces) at birth are FIGURE 5.2 Spina bifida rates and number of live births with spina bifida, 1991–2003 Adapted from "Figure 1. Spina Bifida Rates, 1991–2002," and "Table 1. Number of Live Births and Spina Bifida Cases and Rates per 100,000 Live Births for the United States, 1991ȁ…
Prior to the 1980s in the United States, the courts were supportive of biologic parents making decisions regarding the medical care of their newborns. Parents often made these decisions in consultation with pediatricians. Medical advancements in the 1970s, however, allowed for the survival of infants who would have not had a chance for survival prior to that time. Parents' and physicians&#x…
Under U.S. law, children under the age of eighteen cannot provide legally binding consent regarding their health care. Parents or guardians legally provide that consent, and, in most situations, physicians and the courts give parents wide latitude in the medical decisions they make for their children. When a parent's decisions are not in the best interests of the child, the state may interv…
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