Resuscitation required, court says


WASHINGTON -- The Supreme Court, acting in a case that has alarmed emergency medical professionals, let stand a lower court ruling that requires hospitals to admit and resuscitate comatose patients, even when doctors say there is no hope for recovery.

Yesterday's ruling grew out of the case of a baby born in 1992 in Fairfax County, Va., with most of her brain missing. Deemed by doctors to have no chance of long-term survival, she was placed on a ventilator and has been repeatedly revived at her mother's insistence.

Doctors disputed the wisdom of such aggressive treatment, but a divided U.S. appeals court ruled in February that federal law requires medical professionals "to provide stabilizing treatment" to a hopelessly ill patient, even when they "consider it morally and ethically inappropriate."

Lawyers for several national medical groups, who pressed the case before the Supreme Court, said the ruling expanded greatly the prevailing interpretation of an 1986 federal law that barred hospitals from refusing to treat poor patients. Unless overturned, it could require hospitals to treat dying patients of all ages aggressively, no matter what their chance of survival, they said.

But "in the Matter of Baby K, 93-2076," the justices left standing the lower court ruling. In response, lawyers for the medical groups say they will ask Congress to amend the law.

"This is the first time to my knowledge that a court has ordered physicians to render medical care over their protests," said Stephan E. Lawton, an attorney representing the American Academy of Pediatrics and the Society of Critical Care Medicine. "Clearly, this is not what Congress intended, but the case is being cited now all over the country," he said.

The Supreme Court's action yesterday does not set a binding legal rule. But as a practical matter, the precedent in the "Baby K" case is likely to be followed elsewhere.

In other action, the court:

* Asked the Justice Department for its view of a 1988 federal law that aims to regulate Native American gambling. The court is likely to enter the high-stakes battle later in its term and resolve disputes over whether states can block casino gambling on reservations.

* Refused to review a U.S. appeals court ruling lambasting the Justice Department for its handling of the deportation of accused Nazi death camp guard John Demjanjuk. This ruling does not prevent the government from seeking to deport the 74-year old former Cleveland auto worker again.

* Dismissed an appeal by women's rights advocates who objected to state laws against "wrongful birth" lawsuits. A Pennsylvania woman sought to sue her doctors because they had failed to tell her of the risks of giving birth to a retarded child or to test the fetus in the womb. But Pennsylvania and eight other states specifically have barred such law suits.

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