Cotiplaints to agencies
,karely result in action '

`Should handicapped infants be
"allowed to die" with the consent of
parents and doctors? This series
probes questions about these chil-
dren - the 5,000 annual "Baby
Doe" cases - that deeply divide
medical, legal and government
authorities.
' .._`   Third in a series

By..Carlton
THE WASHINGTON TIMES

While Justice Department and
Health and Human Services
Department officials are now
refusing even to acknowledge
"Baby Doe" complaints, neither
federal agency has much of a'track
record when it comes to taking
action on hundreds of cases pre-
viously referred to it for investiga-
tion.

Government files and
correspondence obtained by The
Washington Times show that in the
past, federal officials have been
slow to investigate reports of infant
abuse, and, when preliminary
inquiries failed to disprove a com-
plaint, they have been even more
reluctant to take further action.

Records demonstrate that most
cases referred to HHS and virtually
every complaint sent to the Justice
Department have remained in a
state of limbo, officially
unresolved, for months and even
years without action.

In two years, the Justice Depart-
ment has conducted only one"Baby
Doe" investigation. That case
involved a report that a child born
with spina bifida - an exposed
spine - was being allowed to die
untreated in an Illinois hospital.

Robert D'Agastino, the Justice
Department attorney who handled
that investigation, said he found
"clear violations of federal laws"
but, because the baby was eventu-
ally treated and lived, no chargers-
were filed.           .A-
From April 1982 to December

1983, HHS reports it launched
investigations in more than 150
incidents involving alleged with-
holding of medical care from

see REPORTS, page 5A


REPORTS

From pa e
SI A
   rl l/ Ilr rQ8ct
infants born with physical or'men-
tal handicaps.

Of those, only 31 were officially
closed - either because no viola-
tion was found or because the
original complaint failed to provide
enough information to conduct a
thorough inquiry.

The remaining "Baby Doe"
cases, some two years old and
involving hospitals in Indiana, Cali-
fornia, Texas, Michigan, Maryland,
Florida, Louisiana, New York,
Oregon, Nebraska, Virginia and
Arizona, continue to be classified
by HHS as "under investigation" or
"not yet completed."

Even the original "Baby Doe"
case, the first to be filed with the
federal government following the
April 1982 death of a Down's syn-
drome infant in a Bloomington,
Ind., hospital, remains officially
unresolved. "Final administrative
action has not yet been taken,"HHS
records say.

But perhaps the best example of
how federal officials have dealt
with past "Baby Doe" incidents
involves a formal complaint filed by
state Sen. Regina Smith, the
chairwoman of the Connecticut
Public Health Committee.

On June 17, 1982, Sen. Smith, a
veteran Democratic legislator, sent
a three-page letter to the Justice
Department, urgently -requesting
federal investigations into the ques-
tionable deaths of a number of
infants born with physical and men-
tal handicaps in hospitals
throughout the state-particularly
in facilities affiliated with the Yale-
New Haven Medical School.

Accompanying the letter
addressed to the Justice
Department's civil rights chief,
Assistant Attorney General Wil-
liam Bradford Reynolds, were
reams of supportive documents
and testimony amassed by the state
Public Health Committee during a
year-long investigation of the state
hospital system.

Included in those materials was
a New England Journal of Medicine
article written by the Yale-New
Haven Hospital's pediatrics chief.

Dr. Raymond Dult, acknowledging
that during a 20-month period 43
handicapped newborns died in the
hospital's intensive care unit after
medical care was withheld or with-
drawn.

The state health committee
itself, Sen. Smith wrote Mr. Reyn-
olds, turned up 20 additional cases
where many handicapped infants
who might have survived without
"heroic or extraordinary mea-
sures" died after decisions were
made to withhold treatment and
again. in some cases, food and
water. Those incidents, she
explained, were uncovered during
a random sampling of death
records in just 11 hospitals over a
single six-month period.

Records demonstrate
that most cases.. .
have remained in a
state of limbo,
ofJicially unresolved,
for months and even
years.

Specifically, Sen. Smith asked for
federal investigations into commit-
tee reports that:

o "Babies were allowed to starve
to death because they were born
with Down's syndrome" - in one
case over a 23day period.
o Parents with handicapped new-
borns were "given lethal overdoses
by physicians to administer to such
babies at home."
o Doctors  "falsified death
certificates in such cases."
Sen. Smith says she expected a
response to her letter within a few
days, "if only a simple courtesy call
saying they received it."
When none came after two
weeks, she telephoned the Justice
Department to confirm the letter
had arrived.

"They said it had, and I would be
hearing from someone soon," she
said.

Several weeks passed, and she
made more calls - with no appar-
ent success.

"After a while, I finally stopped
calling and just waited," she said.
On Feb. 14, 1983, eight months
after the complaint letter was filed,
the first official acknowledgment
came in - but it wasn't from the
Justice Department.
Caroline Chang, director of
HHS's Boston regional office,
wrote to inform the state legislator
that the office had just received the
materials Sen. Smith had sent to
Washington the previous spring
and was now planning to "initiate
our processing of your complaint."
Mrs. Chang told Sen. Smith that
her office would "complete its
investigation in approximately 90
days" and, "if no violation is identi-
fied," both she and Yale-New Haven
hospital would be notified "in writ-
ing."

That was more than a year ago. It
was also the last Sen. Smith heard
from any federal agency concern-
ing the complaint she filed two
years ago last month.
HHS records list the Yale-New
Haven Hospital investigation as
"continuing."

Sen. Smith is skeptical and, she
says, frustrated.

"Bureaucratic procrastination
could account for some delay but
not this," she said. "The problem is
that, when you're dealing with hos-
pitals, you're dealing with powerful
institutions, the sacred cows in
every community.

"How dare anyone go in and sug-
gest something is wrong, some-
thing unethical is going on?
Physicians are always the good
guys in our society. Now all of sud-
den some of us are finding out there
are some doctors out there who
think you're better off dead
because you happen to be retarded,
or you might sit in a wheelchair.

"Of course, that's criminal," she
said. "But when we have doctors
actually admit in writing and under
oath that this is going on in the hos-
pitals and when we have these lives
at stake. . and then for the federal
government to move at this slow
pace - to do nothing for years -
that is a criminal act in itself."

Ibmorrow: HHS Secretary Mar-
garet Heckler at center of "Baby
Doe" policy battle.      1