ABSTRACT

One of the most perplexing dilemmas of modern medicine concerns whether "ordinary" 1 medical care justifiably can be withheld from defective newborns. Infants with malformations of the central nervous system 2 such as anencephaly, 3 hydrocephaly, 4 Down's syndrome, 5 spina bifida, 6 and myelomeningocele 7 often require routine surgical or medical attention 8 merely to stay alive. Until recent developments in surgery and pediatrics, these infants would have died of natural causes. Today with treatment many will survive for long periods, although some will be severely handicapped and limited in their potential for human satisfaction and interaction. Because in the case of some defective newborns, the chances are often slim that they will ever lead normal human lives, it is now common practice for parents to request, and for physicians to agree, not to treat such infants. Without treatment the infant usually dies.