The Journal of Medical Humanities and Bioethics

, Volume 7, Issue 2, pp 79–90

Death by non-feeding: Not in the baby's best interests

  • Helga Kuhse
Article

Abstract

It has recently been suggested that doctors have a duty to act in their patient's best interest and that this duty demands that life-sustaining treatment—including food and fluids—should sometimes be withheld or withdrawn and the patient allowed to die. In this article, the author explores the scope of the ‘best interests principle’ in the context of treatment decisions for seriously handicapped newborn infants. She argues that those who hold that it is permissible to starve or dehydrate an infant to death are mistaken to think that this course of action is in the infant's best interests. While it may be true that there are times whendeath is, everything considered, in an infant's best interests, a slow and distressingmethod of bringing death about is not. Since death by dehydration and starvation is not benign, the withholding of food and fluids is generally not in an infant's best interests. The author concludes by suggesting thatwhenever the withdrawal or non-employment of life-sustaining means imposes a heavy burden on the infant, the ‘best interests principle’ would demand that the infant be killed rather than allowed to die.

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Reference notes

  1. 1.
    President's Commission for the Study of Ethical Problems in Medicine and Behavioral Research:Deciding to Forego Life-Sustaining Treatment, Washington, D.C.: Government Printing Office, 1983, pp. 126–136 and 197–228.Google Scholar
  2. 2.
    World Medical Assembly. Statement on terminal illness and boxing: 35th Medical Assembly, Venice, Italy, October 1983,Medical Journal of Australia 1984, Vol. 140, p. 431.Google Scholar
  3. 3.
    For the final rule seeFederal Register, 45 CFR Part 1340, April 15, 1985, pp. 14678–901; for a discussion and critique of earlier versions of the rule see Peter Singer and Helga Kuhse: “The Future of Baby Doe” inNew York Reviews of Books, Vol. XXXI, No. 3, March 1, 1984, pp. 17–23.Google Scholar
  4. 4.
    In re Infant Doe, No. GU 8204-00 [Cir. Ct. Monroe County, Ind., April 12, 1982], writ of mandamus dismissed sub nom.State ex rel. Infant Doe v. Baker, No. 482 S140 [Indiana Supreme Ct. May 27, 1982]Google Scholar
  5. 5.
    See Helga Kuhse and Peter Singer:Should the Baby Live? Oxford, New York, Melbourne: Oxford University Press, 1985, Chapter 1Google Scholar
  6. 6.
    Report pp. 218–9Google Scholar
  7. 7.
    Report, p. 90Google Scholar
  8. 8.
    American Academy of Pediatrics v. Heckler, No. 83-0774, U.S. District Court, D.C., April 24, 1983.Google Scholar
  9. 9.
    Report pp. 218–9; see, however, also Michael Tooley:Abortion and Infanticide, Oxford: Clarendon Press, 1983; Christina Hoff Sommers: “Tooley's Immodest Proposal,”Hastings Center Report Vol. 15, June 1985 pp. 39–42; and Helga Kuhse: “Interests”,Journal of Medical Ethics, Vol. 11, September 1985. pp. 146–149.Google Scholar
  10. 10.
    Aubrey Milunsky:Know Your Genes, Penguin, 1980, p. 172Google Scholar
  11. 11.
    see ref. [8]Google Scholar
  12. 12.
    James Rachels: “Euthanasia, Killing, and Letting Die”, in [ed.] John Ladd:Ethical Issues Relating to Life and Death, New York, Oxford: Oxford University Press, 1979, p. 159.Google Scholar
  13. 13.
    Report, pp. 65–77.Google Scholar

Copyright information

© Human Sciences Press 1986

Authors and Affiliations

  • Helga Kuhse
    • 1
  1. 1.Centre for Human BioethicsMonash UniversityClaytonAustralia

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