MONTPELIER — Medical ethics experts say the case of a critically injured infant girl highlights questions about when to withdraw treatment from babies and if a parent charged with causing the injuries should be allowed to participate in any discussion about that care.
Normally, even if a child is in state custody efforts would be made to involve the parents in any decisions about medical care, said Dr. Robert Macauley, a physician who specializes in end of life care for children at Fletcher Allen Health Care in Burlington.
"They are still the parents," said Macauley, who was speaking hypothetically and didn't have any direct knowledge of the case of the 2-month-old Springfield girl now in critical condition at Dartmouth Hitchcock Medical Center in Lebanon, N.H. "They are innocent until proven guilty... You want them to be in the loop."
The Springfield case is complicated because the girl's father, Andrew L. Bedner Jr., 28, is facing charges of aggravated domestic assault and, if the baby dies, could face additional charges.
"The issue of mixed motivations is going to be huge," Macauley said.
Court records say Bedner told investigators he "completely lost control" on July 28 when the then 7-week-old baby wouldn't stop crying. The baby was later found to have multiple skull fractures, hemorrhages, multiple rib fractures in different stages of healing and "devastating brain injuries."
Bedner pleaded not guilty Monday to two counts of aggravated domestic assault. He is being held for lack of $100,000 bail. If convicted, he could be sentenced to 15 years in prison on each count.
Officials won't say if there are discussions under way to remove life support from the baby. But the court documents said the injuries suffered by the baby would likely be permanent and that she was unresponsive after being hospitalized.
Bedner's attorney, David Sleigh, said his client wanted to be made aware of any decisions about any changes to the medical care his daughter is receiving and it appeared he would get that opportunity.
"After some preliminary legal research and discussions with other parties involved, it appears we all agree that the family court has jurisdiction," Sleigh said.
Sleigh said his client would most likely get a chance to be involved in decisions about the baby's medical care.
Windsor County State's Attorney Robert Sand said his office didn't want to be involved in any decisions about medical care.
"It is certainly conceivable that medical decisions could ultimately influence what the appropriate criminal charges should be," Sand said.
But Sleigh said it would be unreasonable for Bedner to argue to keep the child alive.
"As the father, he has the right to advocate for the best interest of the child. Advocating for the best survival of his child, on the surface, there's nothing wrong with it," Sleigh said.
Court documents say the baby was taken into state custody on July 29, hours after she was hospitalized.
Macauley said the end-of-life issues for children were most commonly associated with extremely premature babies. "It's a pretty hot topic of conversation," Macauley said.
It's a gray area for the law as well as medicine.
"Some ethicists believe you should never remove someone from life support," said Vermont Law School professor Cheryl Hanna. "Essentially, people believe in miracles. If someone is on life support, you want to leave them on life support indefinitely. With a child that argument becomes that much more compelling."
Many of the issues are spiritual and ethical rather than legal, Hanna said.
"The law doesn't do a very good job in sorting out those spiritual and ethical beliefs. We defer to family and caretakers and the preference of the party themselves. Here's a case that's complicated by the state's interest."MORE IN Central Vermont
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