Newman S A
New York Law School.
Am J Law Med. 1989;15(1):1-60.
In its amendments to the Child Abuse Prevention and Treatment Act, Congress set forth a strict standard for treatment of impaired infants. The statute, shaped by right-to-life groups and certain medical organizations, calls for aggressive treatment in virtually all cases, regardless of the degree of suffering imposed and the burdens and risks involved. The federal rule evidences deep distrust of parental decisionmaking, relegating most parents to a nonparticipatory bystander role. Congress did not make its rule binding on the states. Rather, it conditioned the receipt of federal funds upon incorporation of the rule into each state's law. Most states have accepted the condition, largely through rulemaking by state child abuse agencies. This article challenges the authority of state administrators to promulgate these rules, and argues that state constitutions, little mentioned in the Baby Doe debate thus far, may prohibit many states from adopting the federal standard. Ordering medical interventions that perpetuate extreme conditions of physical and mental devastation, subjecting infants to grave suffering for uncertain benefits, and depriving parents of virtually all decisionmaking power violates the norm of governments constitutionally committed to individual liberty, human dignity and family autonomy. A constitutionally sound approach to this issue would permit careful, ethical deliberation, attention to the individual circumstances of each infant Doe and a reasonable degree of parental control.
在对《预防和治疗虐待儿童法案》的修订中，国会为治疗受损婴儿制定了严格标准。该法规由生命权组织和某些医学组织促成，要求在几乎所有情况下都进行积极治疗，无论所带来的痛苦程度以及所涉及的负担和风险如何。联邦法规表明对父母决策的深深不信任，将大多数父母沦为无参与权的旁观者角色。国会并未使该法规对各州具有约束力。相反，它将获得联邦资金的条件设定为将该法规纳入每个州的法律。大多数州已接受该条件，主要是通过州虐待儿童机构的规则制定来实现。本文质疑州行政人员颁布这些规则的权威，并认为在迄今为止的“婴儿多伊”辩论中很少被提及的州宪法，可能会禁止许多州采用联邦标准。下令进行医疗干预，使身心遭受极度破坏的状况永久化，让婴儿承受巨大痛苦却只为不确定的益处，并且几乎剥夺父母所有决策权，这违反了宪法规定致力于个人自由、人类尊严和家庭自治的政府规范。对此问题采用符合宪法的合理做法应允许进行审慎、符合道德的审议，关注每个婴儿多伊的具体情况以及给予父母合理程度的控制权。
