Perhaps Baby Fae's short life has added to the store of medical knowledge. Even that is still not clear. But the quest for knowledge cannot by itself justify inflicting suffering upon a helpless infant. The only justification could be that the medical procedure to which she was subjected -- implantation of a baboon's heart in place of her own faulty organ -- offered a chance for her survival that was not only real but also better than any less radical alternative. In Baby Fae's case, there is serious question whether those conditions were met.
Dr. Leonard Bailey, who headed the transplant team at Loma Linda University Medical Center, insists that his aim in performing the operation was not experimental but therapeutic. But a doctor who has devoted much of his career to experimenting with animal-to-animal transplants (thus far without success for more than a few months) may not be the best judge of whether it was likely that his technique could sustain the life of an infant for more than a brief period. True, the procedure was approved by an internal review board at Loma Linda before the idea was raised with the baby's mother. But it is also questionable whether the members of the review board at this hospital were qualified to make a decision that lies on the outer boundaries of both medical knowledge and ethical thought.
The ethical issue that concerns us has nothing to do with whether it is right to sacrifice a healthy animal to save a dying human -- animals are sacrificed daily for much less important purposes. If advances in medical science ultimately make animal-to-human organ transplants a generally successful procedure, we have no question that they should be pursued. The issue is whether the operation offered real hope and the only hope for Baby Fae.
Very little is known in the larger medical community about Dr. Bailey's earlier research. But so far animal organ transplants have not succeeded even among animal species, much less with humans. Medical experts are always hesitant to second-guess each other's work, but from what is known, it appears that the chances for success with Baby Fae would have to be judged very small -- especially beyond the first weeks of her life when her immune system developed. Against that very small chance must be weighed the fact that other procedures with more promising track records (a human heart transplant or a palliative operation) were available.
It's not clear whether Baby Fae's estranged parents fully understood the choices available for her treatment before agreeing to the baboon transplant; the hospital's reluctance to provide full information on this score is not reassuring. But no effort seems to have been made to seek a human heart or to transfer her to another hospital where a human heart transplant or corrective operation might have been performed. Loma Linda has neither procedure in its repertoire of approved programs.
Loma Linda's institutional review board has already given Dr. Bailey and his team permission to perform four more baboon heart transplants. Because no federal money is required, even internal approval is not required. But without much greater knowledge and consensus in the medical community about the procedure -- and preferably not before successful use on a fully consenting adult -- the Loma Linda doctors would be wise to refrain from further experiments with infants.