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Baby K: Medical Futility and the Free Exercise of Religion

Published online by Cambridge University Press:  01 January 2021

Stephen G. Post
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Extract

Pediatricians provided expert testimony that, in the case of Baby K, provision of ventilator support goes beyond accepted standards of care for anencephalic infants and so is medically futile. This argument, however reasonable, does not persuade those who believe in the absolute value of even a fraction of human life. In Baby K, court records indicate that Ms. H, Baby K's mother, persistently adheres to the sanctity-of-life principle on religious grounds.

While I think that quality-of-life considerations have a role in medical decision making, those who reject such considerations must be respected. This article makes the following claims, on behalf of religious dissenters: (1) the Baby K case should be interpreted in light of the freedom of religion guaranteed in the First Amendment (“Congress shall make no law respecting an establishment of a religion, or prohibiting the free exercise thereof”); (2) religious beliefs should not be trivialized in clinical ethics, even if reason, not belief, is the language of the public forum; (3) the time-honored free exercise clause (“or prohibiting the free exercise thereof ”) is essential to the American experiment in liberty and should not be overridden in the name of a concept as vague as futility; and (4) free exercise of religion deserves serious discussion in the futility debate, and significant religious accommodation must be included in any hospital or societal futility policies. In the concluding section, issues are raised regarding the balance between religious consideration and resource allocation.

Type
Article
Information
Journal of Law, Medicine & Ethics , Volume 23 , Issue 1 , Spring 1995 , pp. 20 - 26
Copyright
Copyright © American Society of Law, Medicine and Ethics 1995

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References

Kuhse, Helga, The Sanctity-of-Life Doctrine in Medicine: A Critique (New York: Oxford, 1987).Google Scholar
Ibid., p. 23.Google Scholar
Ibid., p. 24.Google Scholar
Hunter, James Davison, Culture Wars: The Struggle to Define America (New York: Basic Books, 1991).Google Scholar
Wolfensberger, Wolf, “The Growing Threat to the Lives of Handicapped People in the Context of Modernistic Values,” Disability & Society, 9, no. 3 (1994): 395–412.CrossRefGoogle Scholar
In the Matter of Baby K, 832 F. Supp. 1022 (E.D. Va. 1993).Google Scholar
Kapp, Marshall B., “Futile Medical Treatment: A Review of the Ethical Arguments and Legal Holdings,” Journal of Internal Medicine, 9 (1994): 170–77.Google Scholar
In the Matter of Baby K, supra note 6, at 4.Google Scholar
Ibid., at 8.Google Scholar
Ibid.Google Scholar
James Reichley, A., Religion in American Public Life (Washington, D.C.: The Brookings Institution, 1985), p. 167.Google Scholar
In the Matter of Baby “K”, 16 F.3d 590 (4th Cir. 1994).CrossRefGoogle Scholar
Brief of the American Academy of Pediatrics as Amicus Curiae, United States Court of Appeals for the Fourth Circuit, Record No. 93-1899 (L), Sept. 13, 1993; and Society of Critical Care Medicine as Amicus Curiae, United States Court of Appeals for the Fourth Circuit, Record No. 93-1899 (L), Sept. 3, 1993.Google Scholar
Annas, George J., “Asking the Courts to Set the Standard of Emergency Care—The Case of Baby K,” N. Engl. J. Med., 330 (1994): 1542–45.CrossRefGoogle Scholar
Boozang, Kathleen M., “Death Wish: Resuscitating Self-Determination for the Critically Ill,” Arizona Law Review, 35, no. 1 (1993): 23–85.Google Scholar
Carter, Stephen L., The Culture of Disbelief: How American Law and Politics Trivializes Religious Devotion (New York: Basic, 1993), p. 3.Google Scholar
Ibid., p. 14.Google Scholar
Ibid., p. 15.Google Scholar
Ibid., pp. 235–58.Google Scholar
Miles, Steven H., “Informed Demand for ‘Nonbeneficial’ Medical Treatment,” N. Engl. J. Med., 325 (1991): 512–15.CrossRefGoogle Scholar
Kauper, Paul G., Religion and the Constitution (Baton Rouge: Louisiana State University Press, 1964), p. 22.Google Scholar
Ibid.Google Scholar
Battin, Margaret P., Ethics in the Sanctuary: Examining the Practices of Organized Religion (New Haven: Yale University Press, 1990).Google Scholar
Reichley, , supra note 11, p. 121.Google Scholar
Tribe, Lawrence H., American Constitutional Law (Mineola, NY: The Foundation Press, 1978), p. 821.Google Scholar
Locke, John, A Letter Concerning Toleration, ed. Tully, James H. (Indianapolis: Hackett, 1983 [1689 original]).Google Scholar
See Blau, Joseph L., ed., Cornerstones of Religious Freedom in America: Selected Basic Documents, Court Decisions and Public Statements (New York: Harper & Row, 1964); see also Stokes, Anson Phelps Pfeffer, Leo, Church and State in the United States (New York: Harper & Row, 1964).Google Scholar
Lord Acton, “The History of Freedom in Ancient and Modern Europe,” in Dewey, Robert E. Gould, James A., eds., Freedom: Its History, Nature, and Varieties (New York: Macmillan, 1970), pp. 29–48.Google Scholar
Hill, Christopher, The World Turned Upside Down (New York: Penguin, 1984).Google Scholar
Kelsey, Morton T., Psychology, Medicine & Christian Healing (San Francisco: Harper & Row, 1973).Google Scholar
See Neal, Emily Gardiner, Celebration of Healing (Cambridge, MA: Cowley, 1992).Google Scholar
Lantos, John D. et al., “The Illusion of Futility in Clinical Practice,” American Journal of Medicine, 87 (1989): 81–84.CrossRefGoogle Scholar
Youngner, Stuart J., “Who Defines Futility?,” JAMA, 260 (1988): 2094–95.CrossRefGoogle Scholar
Ibid., p. 2095.Google Scholar
Truog, Robert D. Brett, Allan S. Frader, Joel, “The Problem with Futility,” N. Engl. J. Med., 326 (1992): 1560–64.CrossRefGoogle Scholar
New Jersey Statutes Annotated, Title 26, Cumulative Annual Pocket Part, Health and Vital Statistics (St. Paul: West, 1994), 26: 6A–5, p. 233.Google Scholar
Botkin, Jeffrey R. Post, Stephen G., “Confusion in the Determination of Death: Distinguishing Philosophy from Physiology,” Perspectives in Biology and Medicine, 36, no. 1 (1992): 129–38.CrossRefGoogle Scholar
Ibid., p. 136.Google Scholar
See Wildes, Kevin W., ed., special issue: Toleration and Bioethics in Journal of Medicine and Philosophy, 19, no. 2 (1994). The principal work in the field, which takes religious ethics seriously, is Reich, Warren T., ed., The Encyclopedia of Bioethics (New York: Macmillan, 2nd ed., 1994).Google Scholar
Meilaender, Gilbert, “Terra es animata: On Having a Life,” Hastings Center Report, 23, no. 4 (1993): 25.CrossRefGoogle Scholar
Ibid., p. 29.Google Scholar
Ibid., p. 32.Google Scholar
Barth, Karl, The Doctrine of Creation, Vol. III, Part Four, trans. Mackay, A.T. (Edinburgh, T. Clark, T., 1961).Google Scholar
Post, Stephen G., “Psychiatry and Ethics: The Problematics of Respect for Religious Meanings,” Culture, Medicine, and Psychiatry: An International Journal of Comparative Cross-Cultural Research, 17, no. 4 (1993): 363–83; Larson, David B. Post, Stephen G., “Religious Content in the DSM-III-R Appendix C: The Glossary of Technical Terms,” American Journal of Psychiatry, 150, no. 12 (1993): 1884-85; Post, Stephen G., “DSM-III-R and Religion,” Social Science and Medicine: An International Journal, 35, no. 1 (1992): 81-90; Post, Stephen G., “Psychiatry, Religious Conversion, and Medical Ethics,” Kennedy Institute of Ethics Journal, 1, no. 3 (1991): 207–23; see also Post, Stephen G., Inquiries in Bioethics (Washington, D.C.: Georgetown University Press, 1993).CrossRefGoogle Scholar
Post, Stephen G., “Health Care Rationing?,” America, 167, no. 18, (1992): 453–55.Google Scholar
Meleis, A.I. Jonsen, Albert R., “Ethical Crises and Cultural Differences,” Western Journal of Medicine, 138 (1983): 889–93.Google Scholar