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September 2, 1988

Anencephalic Newborns as Organ Donors

Author Affiliations

Northeastern Ohio Universities College of Medicine Youngstown, Ohio

Northeastern Ohio Universities College of Medicine Youngstown, Ohio

JAMA. 1988;260(9):1239. doi:10.1001/jama.1988.03410090067018

To the Editor.—  I disagree with a number of points in the commentary by Arras and Shinnar concerning anencephalic organ donation.1 First, throughout the commentary they maintain that any use whatsoever of such babies is immoral. To use them, even with parental consent, is to violate their autonomy. This principle, if accepted, would morally outlaw all research that involves anencephalics and would, if applied generally, put an end to all pediatric research.Second, the parents of the anencephalic are its guardians. Since the question about the welfare of an anencephalic is difficult if not impossible to answer objectively and universally, it is best to let parents, in their role as guardians, make these decisions. This accords with the Presidential Commission's principle that when therapy is futile the parents of the infant should have the authority to discontinue or withhold treatment. This principle applies to the anencephalic case. Clearly, treatment