Neonatal Care for Premature Infants

To the Editor:

John Robertson, in his article, "Extreme Prematurity and Parental Rights after Baby Doe" (HCR, July-Aug 2004), argues that parents should give up their right to refuse aggressive, experimental treatment for marginally viable fetal infants. Since he chose to highlight our daughter's case, Miller v. HCA, I was surprised he neglected to inform readers that he was prepared to argue the same points as a paid witness on behalf of health care giant HCA in January 1998—until the judge ruled that his testimony was "not relevant to any of the issues in our particular case."

Mr. Robertson apparently feels the need to be heard and has chosen the Hastings Center Report as his bully pulpit. Unfortunately, I find myself again correcting the same half-truths, distortions, and factual misrepresentations that the hospital attempted to use to overturn the jury award in my daughter's case. That jury found that HCA violated Texas law and was guilty of "gross negligence" when a hospital administrator ordered a neonatologist into the delivery room without the required and express consent of the parents to treat.

Here are the relevant—and undisputed—facts: After a lengthy consultation with my wife's physician and the neonatologist on call that day, we opted for compassionate care based on the recommendation that the alternative aggressive treatments would almost certainly cause painful, life-long illness and disability. The hospital had nearly 11 hours before the actual birth to follow the established legal procedures, sanctioned by no less an authority than the Supreme Court, to override our decision. Instead, a hospital administrator stepped in and claimed an arbitrary—and, as the jury learned, nonexistent—hospital "policy" to justify immediate resuscitation.

I presume Mr. Robertson is familiar with the testimony put forth in Miller v. HCA. I challenge him to point out where, during the week-long trial, HCA argued that Sidney's birth was an "emergency" situation. That "defense" wasn't put on the record until HCA's lawyers appeared before the Texas Supreme Court, which, not coincidentally perhaps, used it as the primary justification for its decision to overturn the jury award.

Mr. Robertson seems to believe that HCA's actions were justified because "all parties except the father thought there was a consensus that if the child was born alive, and vigorous, it would be resuscitated." Consensus does not equal consent—especially when the legitimate consenter was present and did not grant permission. Again, the jury found that HCA had literally all day to either obtain that consent from my wife and me, or find a judge who would order it, per established hospital and legal procedure.

Once again I find the need to respond to comments and facts that are inaccurate and constructed after the fact to support the hospital's unfortunate decision and actions to order experimental treatment alternatives. My daughter was not born disabled. The treatment protocol chosen and inflicted by the hospital, over our express objection, caused the damage, pain, and disabilities Sidney endures today. The hospital's decision, in light of established Texas law and their own accepted accreditation policies in place, was little more than a rescue fantasy that doomed my daughter to the very conditions we attempted to protect her from.

Unquestionably, by law and tradition, only the parents have the right to make difficult decisions regarding treatment alternatives for their children, and never should hospital administrators acting in behalf of giant health care corporations be entitled to control treatment decisions for any family. Many parents, informed of the grueling, experimental and damaging measures involved in resuscitation of these near-viable fetal-infants, make the decision to provide supportive comfort care only, without invasive high-tech heroics. It is the very kind of humane care my wife and I would want for ourselves if we were in our daughter's situation, facing excruciating treatments that would lead merely to a life of suffering.

Those who overruled our wishes, and their paid defenders like Mr. Robertson, are not required to pay...