"Better Off Dead?," today's "Frontline" (9 p.m., Channel 26), is a moving yet dispassionate look at a controversy that stirs the strongest of passions -- whether or not to use medical high tech to save the lives of threatened newborns, no matter how brain damaged and handicapped they would be should they live.
It is a problem of agonizing choices, one that sets physician against physician, that tears marriages apart, that turns nurses and friends -- or even strangers -- into "interested parties" who report on perceived abuses and at times add to the already heavy burden of parents of birth-defective newborns by bringing lawsuits.
Because of the depth of feelings about the Baby Doe dispute, no partisans are likely to be entirely happy with this program. Yet is is probably the most straightforward presentation of the issue to appear on the televison screen. It was produced by a consortium of Public Broadcasting stations in Seattle, Boston, New York, Miami and Detroit, with Graham Chedd as producer and Andrew Liebman as coproducer.
Each side is presented by its most concerned advocates, from U.S. Surgeon General C. Everett Koop ("You can't say that just because we don't like what we have, you are going to get rid of it," he says) to the anguished mother of a brain-damaged child. She loves and cares for her deaf, blind, severely retarded 5-year-old, but, she says, "The kinds of medical horrors we are inflicting on our children these days are justifiable only if we could be almost sure the outcome would be a very good one. Just because we have the machines, we are torturing people to life the way we used to torture them to death."
The program opens on a note of hope. A baby nearly asphyxiated at birth is, says the intensive care physician, "paralyzed by medications, on 100 percent oxygen, already on close to maximum support." It is, says the narrator, "a difficult and painful way to start life . . .," but this baby will likely recover, grow up and lead a normal life. In this case, although the cost will run something like $100,000, "no one even considered not using everything available."
The excruciating choices come with the most marginal cases, although even here there are examples of children for whom the professional prognosis is the grimmest possible, developing far beyond expectations, at least for a while.
Those who would most strongly advocate the so-called Baby Doe rules believe that even a breath of life demands the most heroic efforts to prolong it. The parents of a 16-year-old girl who is blind, deaf and frozen at the intellectual level of a 10-week-old believe that her smile is worth it all. As her father says at what has to be the most heartbreaking "sweet 16" party ever televised, "It may not be the kind of life that would fulfill me . . . but she does sense love and sensitivity and warmth. When people say a life can only be productive valuable if it's productive, I can't accept that . . ."
But the anonymous mother of the retarded 5-year-old counters, "Our babies, when they are born, do need protection, and if we parents are taken out of the picture they are going to be at the mercy of modern medical gadgetry, condemned to go through procedure after procedure, operation after operation, and no one will be there to stand up on his behalf and say, 'Let him alone . . . let him go . . .' "