Baby Doe Law

The Baby Doe Law or Baby Doe Amendment is the name of an amendment to the Child Abuse Law passed in 1984 in the United States that sets forth specific criteria and guidelines for the treatment of seriously ill and/or disabled newborns, regardless of the wishes of the parents.

The Baby Doe Law mandates that states receiving federal money for child abuse programs develop procedures to report medical neglect, which the law defines as the withholding of treatment unless a baby is irreversibly comatose or the treatment for the newborn's survival is "virtually futile." Assessments of a child's quality of life are not valid reasons for withholding medical care.

The law came about as a result of several widely publicized cases involving the deaths of handicapped newborns. The parents of these children withheld standard medical treatment for correctable gastrointestinal birth defects, leading to their death by preventing nutrition and hydration. The primary case was a 1982 incident involving "Baby Doe", a Bloomington, Indiana, baby with Down syndrome whose parents declined surgery to fix esophageal atresia with tracheoesophageal fistula, leading to the baby's death. The Surgeon General of the United States, at the time of this incident, C. Everett Koop, argued the boy was denied treatment (and food and water) not because the treatment was risky but rather because he was intellectually disabled. Koop commented publicly that he disagreed with such withholding of treatment. In his decades as a pediatric surgeon, Dr. Koop had repaired hundreds of such defects, with a continually improving rate of success. By 1982, success was nearly certain if the surgery was performed.

A similar situation in 1983 involving a "Baby Jane Doe" again brought the issue of withholding treatment for newborns with disabilities to public attention. Baby Jane Doe was born on October 11, 1983, in New York City, with an open spinal column, (meningomyelocele), hydrocephaly and microcephaly. Surgical closure of the defect and reduction of fluid from her brain would prolong her life, but she would be bedridden, paralyzed, epileptic, and with severe brain damage. The parents consulted specialists, clergy, and social workers. They decided to treat the newborn with antibiotics and bandages, rather than surgery to repair the defect.

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