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December 20, 1976

Interpretation of Article Disputed

Author Affiliations

University of Virginia Medical Center Charlottesville

JAMA. 1976;236(25):2847. doi:10.1001/jama.1976.03270260013013

To the Editor.—  In his article on fetal experimentation (236:281, 1976), Dr Diamond misstates the message of my article.1 Neither in the article he cites nor in others I have written on the subject of the defective newborn did I recommend or suggest that "lives which grossly lack 'quality' (eg, trisomy 21) should be terminated early for their own and society's good."My article raises questions about the "right" of parents to refuse surgery for lethal anomalies, such as intestinal atresia, in newborns with severe, irremediable defects (ie, Down syndrome and microcephaly). In discussing this issue, I did state that "... in my opinion, the doctrine of informed consent should, under some circumstances, include the right to withhold consent." I feel, as do many of my colleagues,2 that physicians are not morally obligated to attempt salvage of each and every malformed fetus and newborn merely because it is within