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That the conduct of human affairs does not always conform to the requirements of the law is a surprise to no one. But in few areas of critical life and death decisions is there such a disparity between commonly recognized principles of law and developing medical practice as exists in the area of withholding lifesaving medical care from infants, notably defective infants. The law is said to restrict physicians and parents from withholding lifesaving treatment from infants for the purpose of causing their deaths. Yet it is reported that it is not uncommon for lifesaving treatment to be denied severely defective infants, and that thousands of infant deaths result each year from this lack of treatment.

This disparity between the law and practice may result from confusion in the medical community about the legal standards for nontreatment decisions, or from the absence of any effective mechanism to enforce the law. The purpose of this article is to clarify important issues regarding the legal standards which should be used in making treatment decisions, and to suggest ways that such legal standards might be enforced.

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