TAILIEUCHUNG - Extreme Prematurity - Practices, Bioethics, And The Law Part 7

Trong những năm 1980, sự phát triển của liệu pháp thay thế surfactant phổi đã cứu sống nhiều hơn nữa những trẻ sơ sinh cực non và giảm bệnh phổi mạn, một trong những biến chứng của trẻ đẻ non sống sót có thở máy. | . LAW Prior to the commission there was a reaction from the White House administration. The publicity surrounding the Infant Doe case was the impetus that prompted President Reagan to direct the Departments of Justice and Health and Human Services HHS to mandate treatment services in future similar cases. 277 To avoid a conflict between federal and state law the latter defining crimes such as homicide and gross negligence 273 new rules were announced pursuant to section 504 of the Rehabilitation Act of 1973 which bars discrimination against the handicapped in programs receiving federal assistance such as hospitals that accept Medicare and Medicaid patients. The new rules barred hospitals from denying medical care to infants on the basis of handicap and violation of this would lead to loss of federal funds. Opposition to any such denial was encouraged by the creation of Baby Doe squads comprised of lawyers administrators and physicians who could be available at short notice to investigate alleged violations of the Act. 277 Accusations that these had occurred could be made anonymously through a toll-free number that was openly advertised and easily seen by anyone visiting or working in neonatal units. But the courts did not support this interpretation of the Rehabilitation Act and the . District Court for the District of Columbia in AAP v. Heckler 280 ruled that it could never be applied blindly and without consideration of the burdens and intrusions which might result. The regulations were revised but were again invalidated by the court. 281 Around the same time two lawsuits were in the courts concerning Baby Jane Doe. 282 This baby was born with a myelomeningocele and hydrocephalus and transferred to the State University of New York campus at Stonybrook. The attending surgeon Arjen Kenscamp recommended immediate surgery but the child neurologist who was involved George Newman advised against this stating later that the child was not likely ever to achieve any

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