Date of Award

9-28-2009

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

First Advisor

Geoffrey Miller

Abstract

FROM MUELLER TO MILLER: DETERMINING STANDARDS FOR DECISIONS REGARDING CRITICALLY ILL NEWBORNS. Tanaz Farzan Danialifar (Sponsored by Geoffrey Miller). Section of Neurology, Department of Pediatrics, Yale University, School of Medicine, New Haven, CT. The controversy surrounding selective nontreatment of critically ill newborns has been ongoing for over three decades. Since ancient times ill, premature, or deformed infants have been treated discriminatorily, and infanticide has been a historically acceptable practice. With medical, moral, and legal progress, infanticide has disappeared and been replaced with selective nontreatment. This raises new ethical concerns such as best interests, quality of life, wrongful life, and parental autonomy; and legal questions regarding medical neglect, privacy, discrimination, and the limits of the Federal Government. Through an examination of relevant medical and legal literature, mass media publications, and both state and federal court decisions, this paper will provide a historical overview of the development of the ethical and legal principles guiding neonatal decision-making. In addition to a review of the historical contexts for treatment decisions regarding vulnerable infants, a discussion of several landmark medical-legal cases will establish the current standards for neonatal decision-making. This historical overview reveals the shortcomings of past and current legislation and the dissonance between current practice, public opinion, and the law.

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