Child Abuse Amendments of 1984: What Are the Issues?

Abstract

With the passing of the Child Abuse Amendments of 1984, the United States government has created a framework for legal intervention into controversial Baby Doe cases where handicapped newborns are denied medical treatment, including hydration and nutrition. Both sides of four issues in this controversy are discussed: (a) the parents' right, after consulting with their physicians, to make the final decision to treat or to forego treatment for their disabled infants; (b) the omission of the notion of "quality of life" from the law; (c) the excessive financial burdens imposed as a result of decisions to treat; and (d) the role of the Infant Care Review Committees. In view of the evidence, the author supports the move toward federal intervention.The recently well-publicized cases of Baby Doe and Baby Jane Doe represent a relatively small group of disabled American newborns with serious but surgically correctable life-threatening conditions whose parents, usually with physicians' counsel and support, refuse permission for the treatment necessary to sustain their lives.Public attention has centered on a special group of cases, infants who have both a correctable life-threatening defect and a permanent, irremediable handicap that is not life-threatening, such as exists in Down's syndrome and Spina bifida cases. As public awareness has grown, so has the controversy. On one side, grassroot medical, legal, and political conservatives have argued for the sanctity of the family and the parents' right to make life or death decisions for their disabled infants. On the other, diverse child advocate groups (e.g., special educators) have championed the cause of these seriously ill newborns. Within the last few years, the federal executive and legislative branches have become involved. Executive rules and directives based on the Child Abuse Amendments of 1984 now make the withholding of treatment from some disabled newborns illegal (Federal Register, 1985). These amendments, which include specific guidelines as to what constitutes medical neglect of disabled newborns, also provide a model for the creation of infant care review committees (ICRC).The new amendments, in conjunction with the nationwide trend toward lowering the legal entrance age of handicapped children into the public schools, may have farreaching effects on the thrust of special education programs. Special educators at all levels of instruction need to be informed of the recently published facts and opinions germane to the issues that preceded the passing of these statutes. Early childhood special educators will be affected by the increased number of those handicapped neonates who may, as a result of the statute's implementation, live beyond projected life spans to enroll in educational programs. The purpose of