Neonatologists, Pediatricians, and the Supreme Court Criticize the “Baby Doe” Regulations

Abstract

Earlier we reported neonatologists’ reaction (Kopelman et al., 1988) to the controversial federal regulations governing the treatment of severely handicapped infants—the “Baby Doe” Regulations (DHHS, 1985). We found that the responding neonatologists were highly critical of these regulations, and that their concerns were similar to those expressed by the United States Supreme Court (Bowen v. Am. Hosp. Ass’n., 1986) in rejecting an earlier set of Baby Doe regulations (DHHS, 1984). This agreement among the neonatologists and legal authorities on the Supreme Court lead us to conclude that these regulations were ill-considered. Some have questioned, however, whether the neonatologists’ negative reaction to these rules as reported in our survey might be biased, since the regulations restrict their daily practice. Others question if neonatologists have an unrealistic, pessimistic picture of severely sick newborns’ prognoses, since they do not generally deal with older children. To help answer these questions, we now present the reaction of nonneonatologist pediatricians to these regulations. These data were collected at the same time as the reported survey. Their responses are similar to the neonatologists’ responses, undercutting both objections to the conclusions of our survey.