An incorrect first name for Sen. Christopher Dodd was given in yesterday's Nat Hentoff column on this page.
In 1874 the coroner for Cook County, Illinois, ended his annual report with what he called "a strain on our public morality." During the preceding year, there had been found within the city of Chicago "not less than 29 corpses of babes, exposed immediately after birth, and 28 hidden in various places."
It was apparently of no comfort to the coroner that the abandonment of unwanted infants had been a traditional practice over the centuries in many societies. Among the Chinese (where daughters in particular were killed); the Spartans and the Eskimos (both left defective newborns to be taken care of by the elements); and the Romans (who recognized a father's right to murder his progeny.)
Over the decades, in civilized nations such as our own, the killing of certain handicapped newborns has been brought indoors to hospital nurseries, lessening the trauma to which coroners might be subjected. Since infanticide is never listed as the cause of death, it is impossible to know exactly how many infants each year are denied medical treatment or nourishment until they stop trying to live. However, the extent of this form of infanticide is indicated in the March, 1983 report, "Deciding to Forgo Life-Sustaining Treatment," by the President's Commission for the Study of Ethical Problems in Medicine: ". . . Decisions to forgo therapy are part of every life in the neonatal intensive care unit; with rare exceptions, these choices have been made by parents and physicians without review by courts or any other body."
During the past couple of years, however, some of these private decisions have become quite public as disability rights groups and right-to-life organizations protest the denial of treatment to infants with Down's syndrome or spina bifida, and protest also the resultant deaths in some of those cases.
The Reagan administration tried to help the Baby Does through various regulations; but the courts made it clear it was up to Congress, not the executive branch, to protect handicapped infants from secret summary judgment. If Congress so desired.
Now Congress, in a historic action, has expressed a clear desire to give handicapped infants due process and equal protection under the law. Late last month, as part of the Child Abuse Prevention and Treatment and Adoption Reform Act of 1984, an amendment was passed that redefines child neglect and abuse to include "the withholding of medically indicated treatment from disabled infants with life-threatening conditions." That also means nourishment. Had this law been in existence in 1982, the Bloomington baby could not have been starved to death because it was retarded.
The new law, signed by the president on Tuesday, does say that physicians will not have to take heroic measures to save the lives of infants born dying. Nor need all possible medical treatment be given if it would be "virtually futile in terms of the survival of the infant," or if the baby is "chronically and irreversibly comatose."
But the law is certainly intended to prevent the kind of American medical judgment that is more appropriate to Sparta and that has been described in the December 1982 Archives of Internal Medicine by Dr. Norman Fost, professor of Pediatrics at the University of Wisconsin: "It is common in the United States to withhold routine surgery and medical care from infants with Down's syndrome for the explicit purpose of hastening death" even though there is abundant evidence that "Down's syndrome does not usually interfere with the experiences and social relationships that make life worth living."
Another provision of the "Baby Doe Protection Law" requires that each state, if it is to get federal grants to deal with child abuse and neglect, must set up a system by which any cases of infants' allegedly being denied life-saving treatment will be reported to state child protection agencies. The cases will then be reviewed, and the child protective agency, as a last resort, has the authority to "initiate any legal remedies" that may save the child from being killed.
The bill would not have been passed except for the extraordinary willingness to actually listen to one another on the part of the right-to-life, medical, and disability rights groups involved in agreeing on the language. Also indispensable were astutely patient members of the staffs of the six senators who shepherded the bill to passage in that body: Orrin Hatch, Alan Cranston, Thomas Dodd, Jeremiah Denton, Don Nickles, and Nancy Kassebaum. And, for much of the way, Ted Kennedy.
But the American Medical Association took a walk. It does not see what business the state has interfering in these tragic decisions, which, it says, should remain privte -- without a hearing for the condemned child. At least the Cook County coroner of 1874 recognized a strain on our public morality when he saw one.