The killing of unwanted babies, commonly known as infanticide, is back in fashion. Few commentators have admitted as much, and few reporters have encouraged them to do so. The journalism on infanticide is rife with error: falsehoods reported as facts, facts not reported at all, and the sacrifice of fact to euphemism. The case of Baby Doe provides examples of all three.

Baby Doe was born in Bloomington, Indiana, on April 6, 1982, with two defects. One was Down’s Syndrome, a chromosomal disorder leading to mental retardation. The other was a malformed esophagus which required surgery so that food could reach the baby’s stomach; the success rate for this operation is 85-90 percent. After conferring with their obstetrician, Dr. Walter Owens, Baby Doe’s parents decided against the operation and against intravenous feedings. When hospital administrators learned of the parents’ decision, they sought a judicial opinion. The following evening, Superior Court Judge John G. Baker held an emergency hearing.

In another hearing, Bobby and Shirley Wright, the parents of a daughter with Down’s Syndrome, offered to adopt Baby Doe, arguing that he had been neglected and abandoned. The attorney for Baby Doe’s parents argued that, far from neglecting their child, the parents Doe were following the course of treatment prescribed by their physician (which was to deny him food and water); and that, since Baby Doe was potentially retarded, his life did not warrant preservation anyway. This last claim was buttressed by Dr. Owens, who testified: “Some of these children . . . are mere blobs. . . . These children are quite incapable of telling us what they feel, and what they sense, and so on.”

Judge Baker ruled for the parents of Baby Doe, and the infant died of starvation that evening.

The media’s errors in reporting the case began with accounts of the “severely retarded baby” born with Down’s Syndrome. Few seemed to know that, on the contrary, there was no way of telling at birth how retarded Baby Doe would be. The IQ’s of people with Down’s Syndrome range between 25 and 60, with a few reaching into the category of normal intelligence. Thus, the “fact” that Baby Doe would be “severely retarded,” a phrase that continues to appear in more recent accounts of the case, was simply wrong.

Errors of omission also abounded. Few reporters or commentators mentioned the success rate for the esophagal surgery; Dr. Owens’s chilling remarks on the stand; the Orwellian argument by the attorney for Baby Doe’s parents that starvation is a legitimate course of medical treatment; or that there is a waiting list for the adoption of children with Down’s Syndrome. NBC News, to its credit, did report that it had received fifty phone calls from parents offering to adopt Baby Doe; for the most part, however, the significance of this was lost on the commentators.

In addition, those who followed mainstream accounts were spared the gruesome observations of doctors and nurses who watched the baby die of starvation. These and other pertinent facts were obscured in a flurry of euphemism, including an editorial in the Washington Post on “The Demise of Infant Doe.” (This was only the beginning of the Post’s distinguished record of opinion on infanticide. In pained approval of the Indiana court’s decision, Post columnist Richard Cohen wrote that “Two things have died—a baby named Infant Doe, and a belief in absolutes. We have all grown up.”)

Considering the accounts of Baby Doe that appeared in the media, it was astonishing that there should have been an uproar over his death. Yet Judge Baker’s decision was denounced by many, including the New York Times. The Times, however, was soon to join hands with the Post, the Wall Street Journal, and countless other guardians of opinion who followed their lead in the second of the Doe cases, that of Baby Jane of Long Island.

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Baby Jane Doe was born on October 11, 1983, with spina bifida, an open spinal column; and with hydrocephalus, excessive fluid surrounding the brain. She needed two operations immediately, both of them routine: one to close her spine and prevent infection, another to install a shunt to drain fluid from her brain. As Dr. George Newman, the physician who advised Baby Jane’s parents to withhold treatment, noted on her medical record, with the first of these operations “the prognosis was for probable . . . walking with bracing.” The second operation, installation of a shunt, was needed to prevent brain damage from hydrocephalus. As Dr. Newman himself later testified, no one knew whether Baby Jane Doe had been born mentally retarded. Nevertheless, her parents followed Dr. Newman’s advice and refused permission for both operations.

These medical facts about Baby Jane Doe emerged during the hearings held on her behalf. They will come as a surprise to those who remember media accounts of her case, for as Nat Hentoff has documented in a series of columns for the Village Voice, several major errors found their way into nearly all the articles and editorials written about Baby Jane.

For one, the New York Times, among others, reported that “With the surgery she could live up to twenty years.” Steven Baer, in National Right to Life News, has traced this error to New York State Supreme Court Justice Melvyn Tanenbaum, who included it in his oral summary of the testimony at the hearings. In fact, however, not even Dr. Newman had been so pessimistic. When asked how long the child might live after surgery, he replied: “There is really no way of placing a limit on it if the surgery is performed.” The cross-examiner then asked, “Could it conceivably be twenty years?” Newman responded, “Twenty years is possible.” The reporters, relying only on Justice Tanenbaum’s summary of the testimony, promptly gave Baby Jane a maximum life expectancy of twenty years, and commentators throughout the country repeated this mistake.

There was also the problem of her “abnormally small head,” which measured 31 centimeters in circumference. This “abnormality” was in fact denied by Dr. Newman’s superior, Dr. Albert Butler, who also favored the parents’ decision but testified that 31 centimeters were “within normal measurements for a baby of that size.” Indeed, the consternation over Baby Jane’s “abnormally small head” was deeply ironic; after all, it was the condition of hydrocephalus—an abnormally enlarged head—that was supposed to account for her allegedly “severe retardation.” According to Dr. David McClone, chief of Pediatric Neurosurgery at Chicago Children’s Memorial Hospital (who has himself treated over 1,000 patients with spina bifida), babies with spina bifida whose head circumference is in the range of 31 centimeters are among “the very brightest.” He added: “It’s the child who has the extremely large head who is at risk for having decreased intellectual development. It’s actually backwards.”

A third example making the rounds, and one compounding an error of fact with euphemism, was that Baby Jane was only being denied “life-prolonging” treatment. The truth was that without the surgery to close her spine, the baby would not live out even the twenty years that the media had, albeit erroneously, allotted her; most spinabifida children who do not receive surgery to close their spines die before they are two years old and suffer throughout from severe infections. But “life-prolonging” proved such a useful phrase that it found its way into the pages of the New York Post, the Daily News, USA Today, and Time, for example, and onto the screen with Lesley Stahl (CBS), Tom Brokaw (NBC), Peter Jennings (ABC), and Ted Koppel (ABC’s Nightline). Thus, an operation that would have saved a child’s life became universally misrepresented as a pointless exercise in medical expertise.

And so, day by day, Baby Jane’s defects were made worse in the media than they ever were made in the womb. Most accounts of her case (and here one must except Newsday, which from the beginning emphasized the evidence for an optimistic prognosis) were shot through with these and other errors, and the few journalists who pointed out as much were ignored.

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But the recent vogue of advocating infanticide has taken subtler forms than it did in the eager pessimism that surfaced in the commentary on Baby Jane Doe. Consider The Long Dying of Baby Andrew.¹ The authors of this book, Robert and Peggy Stinson, were the parents of a boy named Andrew, who was born just before Christmas in 1976. Nearly sixteen weeks premature, Andrew weighed 1 pound, 12 ounces at birth and suffered from numerous disorders, including apnea (interrupted breathing), rickets, sepsis (an infection in the bloodstream), difficulty in taking nutrition, a possible heart defect, and several iatrogenic (or treatment-induced) problems, such as a cleft palate caused by the presence of a breathing tube. The baby died after six months of intensive treatment. The Long Dying of Baby Andrew, which grew out of an article published in the Atlantic, consists of the journals that his parents kept throughout Andrew’s short life.

Although one reviewer had qualms about the Stinsons’ inability to “see other points of view,” all praised the authors for their honesty and courage, and focused on their sensitive portrayal of a family tragedy. To be sure, it would have been possible for the parents of a baby like Andrew to write a heartrending account of the sufferings that they and their child endured. But The Long Dying of Baby Andrew is no such book.

Andrew’s parents assumed, and indeed hoped, that he would die shortly after birth. Instead, the baby lived and was transferred to another hospital that specialized in intensive care for premature infants. For the Stinsons, the tragedy began when they realized that Andrew’s new doctors had no intention of encouraging their son to die. What followed was a bitter war, waged throughout Andrew’s life, between his parents and the medical “establishment.” The latter’s view of the matter can be summarized in a remark made by one of Andrew’s doctors and repeated by the Stinsons throughout the book: “What do you want me to do? Put a pillow over his head?”

For Andrew was living—and living, moreover, with no conclusive evidence that he had suffered brain damage or even that, if he survived the initial months of intensive care, he would endure any serious physical handicap. These are two rather pertinent facts that the book’s reviewers neglected to mention, and there are others, also supplied by the Stinsons. For one of the most astonishing features of their book is that it includes such medical reports as the following, co-signed by two of Andrew’s doctors when the baby was four months old:

Parents are highly intelligent, argumentative & Hostile as well as Fragile emotionally—both are under Psychiatric care & are seeing a marriage counseler as a result of their experience with Andrew.

When placenta previa [an improperly situated placenta] was Dx [diagnosed] the parents decided they would rather have an abortion than risk having a damaged child. However, gestation was too far advanced for abortion. The turmoil created by this decision was Cx [complicated] by the onset of premature labor & delivery of an 800-gram fetus. Not to worry tho. The parents were assured by the obstetrician that the child would die & everyone would be happy. Andrew however refused to die & when apnea intervened the parents were asked to transfer the child to PHC [Pediatric Hospital Center]. Initially they refused saying they only wished the child to be made comfortable. After a time however they relented & the child was taken to PHC. . . .

It has been very difficult taking care of a child so many people hope will die & who is at such high risk of having severe neurologic damage. However—

Each of his many problems are potentially reversible [emphasis added]. . . .

Addendum—In my opinion Andrew is at high risk of being battered if he ever goes home with his parents.

Obviously, it did not occur to the Stinsons—or, for that matter, to the book’s reviewers—that these reports would reveal anything but the profound insensitivity of Andrew’s doctors. Yet this excerpt, like entries by other doctors whom the Stinsons had castigated for keeping their son alive, is a fairer summary of the facts and tone of the Stinsons’ story than any of their admirers has seen fit to give. Almost none thought it pertinent to mention, for example, that Mrs. Stinson could not bring herself to touch or even visit her son for most of his life, because, as she puts it, “I can’t face the nurses, this month’s doctor-stranger—the people who know all about our marriage and our finances and understand nothing about me.” So too, her recurring fear that Andrew’s doctors might be Catholics or Orthodox Jews, and so might have an “ideology” at stake in preserving his life, appears to have gone unnoticed.

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But most reviewers had higher purposes in mind than describing what they had in fact read. Peter Singer and Helga Kuhse, whose essay on the Stinsons’ book was featured as the lead piece on the cover of the March 1 issue of the New York Review of Books, provided an excellent example of the political goals to be served by ignoring the tragedy of Andrew himself. They also gave us a glimpse into yet another dimension of the misrepresentation of infanticide: the role of the “ethicists,” or, as Nat Hentoff has called them, the “multidisciplinarians of death.”

Singer and Kuhse’s essay is an attack on the Reagan administration for attempting to enforce section 504 of the Rehabilitation Act of 1973. The section stipulates that it is unlawful for hospitals receiving federal funds to withhold “nutritional sustenance or medical or surgical treatment required to correct a life-threatening condition” if the withholding is based on the fact that the patient is handicapped. This regulation, Singer and Kuhse charge, interferes with “family decisions in that most tragic, personal, and delicate of situations, the birth of a severely handicapped infant.”

En route to their argument, the authors recite the usual chorus of errors, calling the chances for Baby Doe’s surgery “fair” (they were 85-90 percent), and portraying Baby Jane Doe as a “lifetime burden” and “severely handicapped child” with “no reasonable prospect of a satisfying life.” But Singer and Kuhse are after bigger game than these two infants; they mount nothing less than an attack on the very principle that all lives have equal worth. However it is reached, their conclusion is clear:

The pro-life groups were right about one thing: the location of the baby inside or outside the womb cannot make such a moral difference. We cannot coherently hold that it is all right to kill a fetus a week before birth, but as soon as the baby is born everything must be done to keep it alive. The solution, however, is not to accept the pro-life view that the fetus is a human being with the same moral status as yours or mine. The solution is the very opposite: to abandon the idea that all human life is of equal worth.

As an example of Peter Singer’s writings on infanticide, this passage is in fact considerably restrained. A less fettered version of his thought, “Commentaries: Sanctity of Life or Quality,” appeared in 1983 in Pediatrics, the respected journal of the American Academy of Pediatrics. There, in defending the Indiana’s court’s decision to allow Baby Doe to starve, Singer wrote:

If we compare a severely defective human infant with a non-human animal, a dog or a pig, for example, we will often find the non-human to have superior capacities, both actual and potential, for rationality, self-consciousness, communication, and anything else that might be considered morally significant. Only the fact that the defective infant is a member of the species Homo sapiens leads it to be treated differently from the dog or pig. . . . Humans who bestow superior value on the lives of all human beings solely because they are members of our own species, are judging along lines strikingly similar to those used by white racists who bestow superior value on the lives of other whites, merely because they are members of their own race.

And still earlier, in his book Practical Ethics, published in 1977 by Oxford University Press, Singer suggested that “If there were to be legislation in this matter, it probably should deny a full legal right to life to babies only for a short period after birth—perhaps a month.”

Singer is only one of many “ethicists” who have gained entry to prestigious publications by advocating infanticide. In 1977, for example, the Hastings Center Report carried an article by Anthony Shaw, a pediatric surgeon who introduced new rigor to the practice of infanticide by developing a mathematical formula to determine which handicapped infants should be allowed to live. The formula, QL = NE × (H + S)—that is, “quality of life” equals “natural endowment” multiplied by “contribution of the home” plus “contribution of society”—was a theoretical breakthrough. That year, a team of physicians at Oklahoma Children’s Hospital began testing Shaw’s equation on babies born with spina bifida. Their experiment, which lasted until 1982, was a resounding success. All of the 24 babies who, with their parents’ consent, had been singled out for death had obligingly died. Equally reassuring, the 36 whom the physicians had decided to treat had lived (though one died in an auto crash).

When the medical team published these results in the October 1983 issue of Pediatrics, it turned out that not everyone was as pleased with the experiment that had been undertaken at the Oklahoma Children’s Hospital as the physicians had been. In particular, the criteria employed—such as the parents’ intellectual and financial resources, the infants’ potential to live without a wheelchair, suspected mental retardation, and the availability of social services—were immediately attacked by the program’s antagonists. (What must have been the unkindest cut of all came in February of this year, when, as Carlton Sherwood discovered and reported to the Washington Times, the Oklahoma Children’s Shelter—in which those selected for non-treatment had spent their last days—was closed by state officials for numerous health and safety violations. Its owners were meanwhile charged in a $47-million civil suit with racketeering and fraud.)

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The literature on infanticide has also benefited from the ideas of Drs. Raymond Duff and A.G.M. Campbell, who together or separately have aired their opinions in the New England Journal of Medicine, the Journal of Medical Ethics, Pediatrics, Annals of the American Academy of Political and Social Science, and numerous anthologies devoted to medical ethics.

In 1970, Drs. Duff and Campbell began practicing their own version of “selective non-treatment” on babies at the Yale-New Haven Hospital. Within thirty months, 46 of the infants they had decided not to treat had died. The criteria by which these infants were hastened to the grave included assessments of their ability to “love or be loved,” the likelihood of institutionalization, and the sorrow of their parents. These criteria, as Drs. Duff and Campbell emphasized, were intended not only for cases as extreme as anencephaly (total or partial absence of the brain), but also for “borderline” disorders such as spina bifida, Down’s Syndrome, or multiple defects that might or might not involve the brain. While the doctors have acknowledged that “death as a management option” might be illegal, they add that “If working out these dilemmas in ways such as we suggest is in violation of the law, we believe the law should be changed.”

It should not be supposed that advocates of infanticide are limited to the world of medicine. Most students of analytic philosophy, for example, are acquainted with The Rights and Wrongs of Abortion, a collection of essays published in 1974 by Princeton University Press after first appearing in the journal Philosophy and Public Affairs. Among the contributors is Michael J. Tooley, whose “Abortion and Infanticide” prefigures the work of Peter Singer. Tooley begins with the observation that advocates of abortion must “come to grips” with the issue of infanticide, in part for reasons of consistency, and in part because “if it could be shown that there is no moral objection to infanticide the happiness of society could be significantly increased.” As for distinguishing between infanticide and murder:

The practical moral problem can . . . be satisfactorily resolved by choosing some period of time, such as a week after birth, as the interval during which infanticide will be permitted. This interval could then be modified once psychologists have established the point at which a human organism comes to believe that it is a continuing subject of experiences and other mental states.

Singling out the views of men like Singer, Shaw, Duff, Campbell, and Tooley may seem an unfair way of assessing the state of medical ethics. It is not. Only a few physicians such as Dr. C. Everett Koop (now Surgeon General) and a few moral philosophers like Paul Ramsey have denounced the views of their colleagues, and they have had little effect. Dr. Koop, in particular, has been pilloried in the press for his association with the Right-to-Life movement. Though they quibble over exactly which children should live or die, most “ethicists” differ from a Singer, a Shaw, or a Tooley only in being less candid, or less rigorous, in their support of infanticide.

Yet the ideas of these “ethicists” are scarcely known outside the elite circles in which their writ-tings appear. The story of the Oklahoma Children’s Hospital did not become a national tragedy, and neither did the experiments conducted in New Haven under Drs. Campbell and Duff. In other words, the media’s handling of the Baby Doe cases was merely typical. Newspapers and magazines, erudite journals, philosophical and medical societies—in sum, a fair sampling of the American intellectual elite—have misrepresented or kept silent about the advocacy and practice of infanticide. By now, the reasons for this have become clear.

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Baby Doe died in April 1982—in the middle, that is, of Ronald Reagan’s term in office. Three weeks later, Reagan sent a memo to Richard Schweiker, Secretary of the Department of Health and Human Services (HHS), instructing him to notify hospitals of the contents of section 504. It was this memo that sparked a heated debate in the media over the government’s “intrusiveness” into private affairs. That debate, which intensified when HHS began posting the provisions of section 504 in hospitals throughout the country, reached its peak when the federal government tried to obtain the medical records of Baby Jane Doe.

Commentators portrayed the issue as a conflict between state and private control. In so doing, they attracted the support of those who, while ordinarily sympathetic to Reagan, would come to fault him for violating his commitment to limited government. But in general the Baby Doe cases served as a pretext for liberal elites to attack a popular Republican administration. Thus, two other pertinent facts—that section 504 was part of an Act passed in 1973, and that Reagan’s was not the first administration to attempt to enforce the section’s provisions—were rarely mentioned, and never emphasized.

Yet if the political aim of attacking the Reagan administration partially explains the numerous errors and examples of worst-case thinking that dominated accounts of the Baby Does, what remains to be explained is why these same elites drew a curtain of silence around the subject of infanticide.

In considering this question, it is useful to recall that the literature on infanticide is rife with references to abortion, and that the open advocacy of infanticide began in the early 1970’s with the legalization of abortion-on-demand. For as Singer and Tooley suggest, it is difficult to justify abortion without at least considering what such a position implies about infanticide. After all, as many “ethicists” have themselves pointed out, an infant’s physiology throughout his first month of life is closer to that of a fetus than it is to that of a child.

The theoretical difficulty of distinguishing between abortion and infanticide becomes even more obvious as advances in technology have forced the redefinition of fetal “viability.” The definition offered in Roe v. Wade, for example—28 weeks—is already obsolete; as the Stinsons rightly observe, there was something absurd in protecting Andrew’s emergence from the womb after less than six months of gestation when as a fetus he could legally have been aborted at an even later date.

Thus, infanticide presents the champions of abortion-on-demand with an uncomfortable choice. They can either describe events that seem increasingly arbitrary—like “viability” or birth—as the points at which a fetus or baby obtains its rights, or they can allow, as the more outspoken “ethicists” already have done, that infanticide, or at least certain instances of it, is as justifiable as abortion. Peter Singer frankly admits that he would rather approve infanticide than deny abortion. By contrast, the overwhelmingly liberal members of the media—90 percent of whom, according to a study by Stanley Rothman and Robert Lichter, favor abortion-on-demand—have managed to evade the alternatives by misrepresenting some cases of infanticide and by muting or ignoring others.

In the end, however, these disparate explanations do not satisfy, for they mask what is most unique about the American revival of a pagan practice. Not that the advocates of infanticide ignore its distinguished roots; on the contrary, as Singer has written, and as many have implied, “It is not easy to feel confident that we are more civilized than the best Greek and Roman moralists.” But the new infanticide differs from the old in this crucial respect: it has added another class of infants—those born with real or suspected mental retardation—to the ranks of the defective. Plato and Aristotle have finally been outdone.

It should come as no surprise that advocates of the new infanticide appear and are rewarded in the uppermost circles of the intellectual elite. Those who live by their wits have frequently doubted the value of a life without them. Take Oliver Wendell Holmes, Jr., who in 1926 spoke for the majority of the Supreme Court in a decision that upheld the right of Virginia to sterilize the feeble-minded: “It is better for all the world, if instead of waiting to execute degenerate offspring for crime, or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind.” He added: “Three generations of idiots are enough”—a fillip that should find some favor with our utilitarian advocates of infanticide.

In Holmes’s time, before high technology, only a few mental defectives could be singled out at birth. Now we can find the rest. Of course, like any other discipline, the new infanticide must allow for error, as it evidently did when (as Carlton Sherwood and Mike Taibbi reported in their television documentary Death in the Nursery) a premature infant was allowed to die because his neurosurgeon diagnosed anencephaly, only to have the subsequent autopsy reveal a perfectly formed brain. But advances in technology will surely reduce such mistakes; in the meantime, the apologists for the new infanticide might prefer to do without autopsies.

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¹ Little, Brown, 375 pp., $16.50.