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February 7, 1996

Lost Lullaby

Author Affiliations

University of Michigan Medical Center Ann Arbor

JAMA. 1996;275(5):406. doi:10.1001/jama.1996.03530290078044

Deborah Alecson's account of the birth, life, and death of her infant daughter Andrea is an attempt to draw attention to the issues of parental rights in the determination of medical care for children.

Ms Alecson's labor and delivery appear to have been complicated by intrapartum asphyxia, possibly associated with oxytocin augmentation. The baby was delivered by an emergent cesarean section and was severely depressed at birth, requiring extensive resuscitation and initially mechanical ventilation. She was eventually able to be extubated but was profoundly encephalopathic. When it became clear that the prognosis for functional recovery was dismal, a parental request to withhold all treatment—including provision of fluids and nutrition— was denied. Alecson details her frustration and anger during the ensuing period until the child spontaneously arrested and died at three weeks of age.

The book is written on a primarily emotional level, which will be appealing to parents and lay