AMA Panel Supports Use of Doomed Babies as Organ Donors

Anencephalic babies, born with most of their brain missing, should be available for use as organ donors before they are dead, a policy-setting committee of the American Medical Assn. says.

The proposal to change state laws to allow such transplants has created dissent within the AMA and renewed a debate among ethicists. Critics charge that the practice would amount to killing one patient to save another.

“It is,” acknowledged Dr. John Glasson, chairman of the AMA Council on Ethical and Judicial Affairs, a nine-member committee whose opinions are considered AMA policy.

But anencephalic newborns are doomed and “don’t have any consciousness,” said Glasson, a retired North Carolina orthopedic surgeon.

Donating their organs would help ease a serious shortage for children needing transplants and help the parents of the anencephalic newborns deal with their grief, Glasson said.

But George Annas, a Boston University professor of health law, said: “You can’t kill babies to take their organs, no matter how many lives could be saved.”

The committee proposal appears in today’s edition of the Journal of the American Medical Assn.

About 1,000 to 2,000 U.S. infants are born each year with anencephaly, in which most of the brain, skull and scalp are missing. Such infants have brain stems that allow them to maintain some body functions, such as breathing, sucking and crying.

Fewer than half survive more than a day; more than 90% are dead within a week. Their vital organs deteriorate as they slip toward death, rendering the organs useless for transplants unless removed soon after birth, the AMA committee said.

In 1988, the committee declared that it is ethical to use anencephalic infants as organ donors only after they have died. But the Baby Theresa case in Florida helped change minds on the committee.

In that 1992 case, the baby’s parents learned they had an anencephalic fetus, but instead of an abortion wanted to offer her organs for transplant after birth. The Florida Supreme Court denied the parents’ request because of a state law requiring organ donors to be dead. The baby died nine days after birth, and none of her organs were suitable for transplant.