Selective nontreatment and spina bifida: A case study in ethical theory and application

Defective newborn children are to be considered human persons. Thus, primary duty in proxy consent is to act with the infant's best interest in mind. This duty may at times override the otherwise prima facie right to life, but only under restricted circumstances. Refinements of McCormick's “relational potential” criteria and of ordinary-extraordinary means analysis prove useful in such decisions. Utilitarian considerations of social consequences have impact but can be kept subsidiary. The importance for decision making of available child support services is considered. Spina bifida is used throughout as an example of issues discussed.