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Article
July 8, 1974

To Save or Let DieThe Dilemma of Modern Medicine

JAMA. 1974;229(2):172-176. doi:10.1001/jama.1974.03230400034027
Abstract

ON Feb 24, the son of Mr. and Mrs. Robert H. T. Houle died following court-ordered emergency surgery at Maine Medical Center. The child was born Feb 9, horribly deformed. His entire left side was malformed; he had no left eye, was practically without a left ear, had a deformed left hand; some of his vertebrae were not fused. Furthermore, he was afflicted with a tracheal esophageal fistula and could not be fed by mouth. Air leaked into his stomach instead of going to the lungs, and fluid from the stomach pushed up into the lungs. As Dr. Andre Hellegers recently noted, "It takes little imagination to think there were further internal deformities" (Obstetrical and Gynecological News, April 1974).

As the days passed, the condition of the child deteriorated. Pneumonia set in. His reflexes became impaired and because of poor circulation, severe brain damage was suspected. The tracheal esophageal fistula,

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