Neonatologists Judge the Baby Doe Regulations

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 interests 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. (N Engl J Med 1988; 318:677–83.) THERE has been a good deal of controversy about the current federal regulations governing the treatment of severely handicapped infants — the "Baby Doe" regulations 1 — based on the 1984 amendments to the Child Abuse Prevention and Treatment Act. 2 An earlier version of the Baby Doe regulations, 3 promulgated in 1984 on the basis of section 504 of the Rehabilitation Act of 1973, 4 was struck down by the U.S. Supreme Court on June 9, 1986. 5 Although the substance of the two sets of regulations is similar, the earlier regulations were issued under civil rights law, which states must follow, whereas the . . .