Introduction to the Baby Jane Doe papers

A conference was held at the State University of New York at Stony Brook in October 1984 to discuss the controversy concerning treatment of a newborn with severe congenital defects that became known as the Baby Jane Doe case. Fox provides some background information on the case to introduce a set of of six articles consisting of papers delivered at the conference. These articles deal with historical aspects of the treatment debate (Stanley J. Reiser), problems of clinical decision making (John M. Freeman), the legal issues involved (John A. Robertson), coverage of the case by the media (Stephen Klaidman and Tom L. Beauchamp), federal efforts to regulate the treatment of handicapped newborns (Lawrence D. Brown), and the alliance that arose between opponents of abortion and advocates of the rights of the handicapped (Constance Paige and Elisa B. Karnofsky).     

Baby Jane Doe in the media

A review of national television, magazine, and newspaper coverage of the case of Baby Jane Doe indicates that most of it lacked perspective and context; stories were generally incomplete and often imprecise; reporting was sometimes inaccurate; and overall, inadequate attention was paid to the medical, legal, philosophical, and social implications of the case. Human-interest and political elements of the story were generally well covered. Even after taking account of the pressures and constraints of daily and weekly news reporting, we conclude that the print press and television could have done a better job without devoting more space or time to the story. This could have been done by assigning reporters with greater expertise and by paying more attention to the needs of a hypothetical "reasonable reader."     

Baby Doe, Congress and the states: challenging the federal treatment standard for impaired infants

In its amendments to the Child Abuse Prevention and Treatment Act, Congress set forth a strict standard for treatment of impaired infants. The statute, shaped by right-to-life groups and certain medical organizations, calls for aggressive treatment in virtually all cases, regardless of the degree of suffering imposed and the burdens and risks involved. The federal rule evidences deep distrust of parental decisionmaking, relegating most parents to a nonparticipatory bystander role. Congress did not make its rule binding on the states. Rather, it conditioned the receipt of federal funds upon incorporation of the rule into each state's law. Most states have accepted the condition, largely through rulemaking by state child abuse agencies. This article challenges the authority of state administrators to promulgate these rules, and argues that state constitutions, little mentioned in the Baby Doe debate thus far, may prohibit many states from adopting the federal standard. Ordering medical interventions that perpetuate extreme conditions of physical and mental devastation, subjecting infants to grave suffering for uncertain benefits, and depriving parents of virtually all decisionmaking power violates the norm of governments constitutionally committed to individual liberty, human dignity and family autonomy. A constitutionally sound approach to this issue would permit careful, ethical deliberation, attention to the individual circumstances of each infant Doe and a reasonable degree of parental control.     

Infanticide, physicians, and the law: the "Baby Doe" amendments to the Child Abuse Prevention and Treatment Act

Infanticide, like most other species of homicide, is probably coeval with the human race itself. In modern Western civilization, what were formerly the most powerful incentives to infanticide have virtually disappeared. As with other social problems that affluence has seemed to solve, however, infanticide has reappeared in a new form that seems to have been made possible by affluence itself. This "new infanticide" occurs in a place whose very existence is the result of a tremendously wealthy society's devotion to its most vulnerable and least "useful" members. The modern neonatal intensive care unit, which treats, and often saves, extremely ill newborn children, who during most of history would surely have died, has proven to be a setting where many of the age-old incentives for infanticide have begun to operate again. The "new infanticide" consists of withholding food or needed medical treatment from selected infants who suffer from one or more serious, though treatable, medical problems. The national government has now enacted legislation designed to curtail the practice of infanticide by the medical profession. This paper traces the genesis of that legislation, explores the problem to which it is addressed, and evaluates its prospects for success.     

From Protecting to Promoting: Evolving EU Sex Equality Norms in an Organisational Field

This paper builds on a process–oriented approach which examines constitutionalism with respect to both legislation and social practices. Drawing on the institutionalist concept of the organisational field it provides tools for explaining the emergence of the distinct connectedness and isomorphism of European sex equality norms. The paper elucidates the shifting meaning of sex equality in the field of employment on the one hand, as it demonstrates the close ties between sex equality law and the constitutional status of gender norms on the other. Contrary to both the intergovernmentalist and neo–functionalist approaches in European integration studies, the concept of 'institutionalist field' allows for explication of shifting institutional demands that work beyond the rational interests of the nation–state. The field approach thus emphasises the interrelation between legal and political actors and their respective shared cognition which defines what bears meaning.