Physicians' Refusal of Requested Treatment

The Case of Baby L Revisited

“…&dquo; 9 As pointed out by Paris and colleagues, Lantos and colleagues subscribe to Fleischman's position. 1 Perelman and Fost were less circumspect in opposing the position taken by the Baby L medical team: &dquo;While we support the notion that health care providers should not be compelled to violate deeply held moral views, we also question medical judgments that may threaten the interests of an incapacitated patient. The central question is whether patients who cannot experience the richness of normal life have experiences that make continued existence from their own perspective better than no life at all.…”

Rejecting the Baby Doe Rules and Defending a “Negative” Analysis of the Best Interests Standard

“…Recommendations for compassionate and individualized decisionmaking are the norm in many policies for older children and incompetent adults and are widely supported in the pediatric literature and in other American Academy of Pediatrics policies (May, 1983;Faden et al, 1986;Freeman, 1988;Buchanan and Brock, 1989;Paris, et al, 1990;2001;AAP, 1994;1995;1996;Lantos, 1996;Byock et al, 2001;NHO, 2001). This right-to-life position advocates a policy adults would not want for themselves (Singer, Martin, & Kelner, 1999;Steinhauser et al, 2000).…”

Improving Fairness in Coverage Decisions: Insights from the Harvard Community Health Plan's LORAN Commission Report

“…More difficult were treatments that might extend life, but at the expense of others. ICU placement for a patient in a persistent vegetative state was ruled out, as was ventilation for patients such as Baby L, the two year-old child whose only conscious experience was pain (Paris, Crowe, and Reardon 1990). Her insured hospitalization to date had cost in excess of $1 million and there was no prospect that her medical state would significantly improve.…”