May Reconsider Heart Transplant : Loma Linda Turns Away Unwed Couple’s Infant

Loma Linda University Medical Center, a major infant heart transplant facility, has refused to consider a desperately ill infant as a potential transplant recipient because hospital officials thought his parents would be incapable of providing him special post-operation care, a Roman Catholic priest and a spokeswoman for an anti-abortion group claimed Tuesday.

They said Loma Linda objected to the fact that the parents are young and unmarried.

But Loma Linda is reconsidering its decision because the parents have agreed to relinquish custody of their 10-day-old child to either set of grandparents, according to Father Michael Carcerano of St. Philip’s Catholic Church in Pasadena and Right to Life League of Southern California spokeswoman Susan Carpenter McMillan.

“All we are asking is that little Baby Jesse be placed on the waiting list,” McMillan said. “How can they (Loma Linda officials) throw the baby out with the bathwater simply because they don’t like the family’s circumstances?”

In a development late Tuesday, the family got a call from a hospital official who told the parents to call today and set up a meeting, McMillan said. But the caller did not say specifically that the meeting would concern a transplant, McMillan told the Associated Press.

“I feel hopeful that Loma Linda will reconsider little Jesse’s chance, being that it is mother’s birthday (today) and that would be the best present in the world,” the boy’s father said in a statement released by McMillan.

“It’s an opening of the door. We consider it an important step,” Carcerano said.

Hospital spokesman Dick Schaefer on Tuesday night said he hadn’t heard of the offer for a meeting.

Earlier in the day, Carcerano and McMillan declined at a press conference at the church to identify the couple. They said the child was born with an invariably fatal condition known as hypoplastic left heart syndrome in which the left side of the heart essentially does not function.

Statement on Adoption

McMillan said hospital officials may also have been initially swayed by the parents’ statement that, before the child’s birth, they considered putting him up for adoption because they doubted that they were ready to be parents.

But she characterized the young couple’s notion “an impulsive act” that both quickly abandoned once Jesse was born May 25. And Carcerano said the couple now are committed to keeping and caring for Jesse.

They identified the father as a 26-year-old employee of an air-conditioning and heating company and the mother as a 17-year-old.

In selecting heart transplant recipients, hospitals throughout the country routinely consider social and psychological as well as medical factors--all of which may affect a patient’s recovery.

“If the patient does not have a stable situation at home, all that has been accomplished is to subject him to a highly invasive operation with a lessened chance that he will recover,” said a spokesman for the adult heart transplantation program at Stanford University.

Rationale Challenged

But according to Daniel Callahan, a New York medical ethicist, rejecting transplant candidates on grounds that the home life is unstable “seems to fly in the face of traditional medical ethics, which always emphasizes the welfare of the patient.”

Callahan is director of the Hastings Center in New York, a think tank that deals with ethical issues in medicine.

“If a child doesn’t get a transplant, there is a certainty of death. Otherwise death is only a possibility,” he said in a telephone interview.

Jesse was born in a Los Angeles-area hospital and weighed eight pounds. After his syndrome was diagnosed, the hospital referred his parents to Loma Linda and then put Jesse on drugs to prepare him for a heart transplant.

At Loma Linda, about 60 miles east of Los Angeles, the parents were interviewed by a psychiatrist who is a member of the screening committee for potential transplant recipients. A Loma Linda spokesman said a transplantation committee carefully evaluates each referral, but declined Tuesday to give details of the criteria used by the committee because of confidentiality.

Anti-Abortion Group Contacted

After the infant was turned away, McMillan said, family members contacted Carcerano and the anti-abortion group.

She said her group and Carcerano were told by Loma Linda staff that doctors and administrators there were reluctant to commit their resources to a child whose family life did not seem stable enough to provide the child with intense post-surgery care.

“But our feeling is that no human life should depend on the nature of the family to which the baby was born,” she said.

Carcerano predicted that the parents’ willingness to place Jesse in the custody of either set of grandparents--both of which, he said, are warm, loving, extended families--should persuade Loma Linda to change its mind.

“This baby will receive a lot of care and a lot of support if only he is given a chance at survival,” the priest told reporters.

McMillan quoted Jesse’s mother as having stated on Tuesday:

“I will be 17 years old tomorrow. Please, Loma Linda, give my baby a chance to reach his first birthday.”

Alexander M. Capron of the USC Law Center, said the issues raised in this case are complex and “as old as medicine.” In experimental treatments such as infant heart transplants, physicians have considerable leeway in deciding whether to accept or reject a candidate because they are dealing with such a scarcity of donor organs.

“Not to fix a broken arm would be challenged, but there is no comparable basis for a challenge when the procedure is on the frontier of medicine,” Capron said.