Kopelman L M, Irons T G, Kopelman A E
Department of Medical Humanities, East Carolina University School of Medicine, Greenville 27858-4354.
N Engl J Med. 1988 Mar 17;318(11):677-83. doi: 10.1056/NEJM198803173181105.
The federal regulations now in effect governing the treatment of severely handicapped infants--the so-called Baby Doe regulations--are based on the 1984 amendments to the Child Abuse Prevention and Treatment Act; these regulations require that, except under certain specified conditions, all newborns receive maximal life-prolonging treatment. We sent questionnaires to the 1007 members of the Perinatal Pediatrics Section of the American Academy of Pediatrics to determine their views on the Baby Doe regulations and on whether the regulations had affected their practices; 494 of the members (49 percent) responded. Of the respondents, 76 percent believed that the current regulations were not necessary to protect the rights of handicapped infants; 66 percent believed that the regulations interfered with parents' right to determine what course of action was in the best interest of their children; and 60 percent believed that the regulations did not allow adequate consideration of infants' suffering. In responding to the three hypothetical cases of severely handicapped newborns, up to 32 percent of the respondents said that maximal life-prolonging treatment was not in the best interests of the infants described but that the Baby Doe regulations required such treatment. The responding neonatologists' concerns about the current Baby Doe regulations were similar to those expressed by the United States Supreme Court in rejecting an earlier set of Baby Doe regulations. This similarity suggests that the current Baby Doe regulations should be reevaluated.
目前生效的联邦法规对重度残疾婴儿的治疗进行规范——即所谓的“婴儿多伊法规”——这些法规基于1984年对《预防和治疗虐待儿童法案》的修订；这些法规要求，除某些特定情况外，所有新生儿都应接受最大限度延长生命的治疗。我们向美国儿科学会围产期儿科学分会的1007名成员发送了问卷，以确定他们对“婴儿多伊法规”的看法以及这些法规是否影响了他们的医疗行为；494名成员（49%）进行了回复。在回复者中，76%的人认为现行法规对于保护残疾婴儿的权利并非必要；66%的人认为这些法规干涉了父母决定何种行动最符合其子女利益的权利；60%的人认为这些法规没有充分考虑婴儿的痛苦。在回应三个重度残疾新生儿的假设案例时，高达32%的回复者表示，最大限度延长生命的治疗并非所描述婴儿的最佳利益，但“婴儿多伊法规”要求进行这种治疗。回复的新生儿科医生对现行“婴儿多伊法规”的担忧与美国最高法院在驳回早期一套“婴儿多伊法规”时所表达的担忧相似。这种相似性表明，现行的“婴儿多伊法规”应该重新评估。
