The Legislation tries to take into account infants born alive, including those who survive abortion under federal law. The change was implemented in 2001, with overwhelming support from the United States' various political parties. The legislators who pushed for this Legislation were Congressman Steve Chabot and Senator Rick Santorum. Important to note is that the law recognizes a ""person"" with the inclusion of an infant who under different circumstances underwent removal from his or her mother and its long-term life is a guarantee (Malloy, 2011). (Malloy, 2011). However, the American Academy of Pediatrics Neonatal Resuscitation Program (NRP) makes it clear that the Born-Alive Infants Protection Act of 2001 should not influence the manner in which physicians treat extremely premature infants.
Despite the progress achieved in the fight against abortion, the National Abortion and Reproductive Rights Action League (NARAL) believes that the Born-Alive Infant Protection Act interferes with the private decisions made during medical treatment. The passing of this Act meant that it would recapitulate the current laws in forty states in the United States during that period. Therefore, those babies born under abortion circumstances were subject to the same constitutional protection and care as other infants. Discrimination against them was not permissible, and their death was not allowed since they were unwanted (Malloy, 2011). The enforcement of the Born-Alive Infant Protection Act into law has never faced any challenge in court. Hence, no constitutionality limitations have been raised against it over the years. However, the Act has created a problem when it comes to the right to abortion. Thus, the intentions of the Act center on issues related to the protections of the law of an infant who survived abortion.
Impact of the Act on the Practice Setting
The passing of the Born-Alive Infants Protection Act has made sure that there are no cases of "medical neglect" as members of Congress believe that medical practitioners were not doing enough. For this matter, the Act has ensured that preserving and resuscitation of infant lives who have managed to survive abortion occur effectively. Further, the Department of Health and Human Services has released a memorandum that ensures there is no confusion when it comes to "medical neglect." It spells out clearly that the “medical neglect” includes the withholding of medical services to infants facing life-threatening conditions (Cohen, 2014). For this reason, due care to the children is mandatory and then reporting the cases to the responsible authorities follows.
However, problems arise when it comes to translating this requirement to the present medical practice setting. Whenever, nurses and other medical practitioners offer Child Protective Services, following the legal steps is important to avoid harming the infant. The case is different when giving reference to the Child Abuse Prevention and Treatment Act (CAPTA) which outlines “medically indicated” treatment with a list of exceptions. Hence, the “medically indicated” treatment is not part of the qualifiers in the particulars of “medical neglect” creating a gap when undertaking medical care under circumstances of abortion. Thus, hospitals should be in a position to offer emergency care whenever extraordinary circumstances arise.
Secondly, the Born-Alive Infants Protection Act has had an impact on the physician practice has it has made them have a strong stand when it comes to respecting parental wishes. The physicians make neonatological decisions either individually or with the parents on whether to resuscitate the baby or take other measures. The norm is that for infants aged 21 weeks, the physicians would decline resuscitation which is not the case for those aged 26 weeks and above. The gray zone lying between the gestation period of 22 and 25 weeks makes it difficult for physicians to undertake the standard action (Dungan, 2012). However, the Act outlines the ethical life or death decisions when it comes to such situations by the subjective criteria which create a conflict.
There are circumstances when the physicians may need to resuscitate a non-viable infant. Such scenarios arise given the guidance of the Born-alive Infants Protection Act which provides for resuscitation of all regardless of the underlying conditions. The Act outlines clearly that "no matter how premature or unlikely to survive," physicians should proceed with the resuscitation procedure. On the other hand, the American Academy of Pediatrics Committee on Bioethics emphasizes on non-resuscitation if the infant is under a marginally viable condition. The fear that medical practitioners have when it comes to litigation under law forces them to encounter challenges when offering medical care.
Lastly, the Born-Alive Infants Protection Act has propagated the behavior of favoring individual beliefs over the actual behaviors in the medical practice setting. The physicians make their decisions depending on the provisions of the Act and fail to follow the gestational age when carrying out the resuscitation procedure (Dungan, 2012). Gestational age is the critical factor when conducting a prognosis during delivery, but it is not considered by most medical practitioners as there is a limitation when considering the provisions of the Born-Alive Infants Protection Act.
Future Expectations, Amendments, and Modifications
The Born-alive Infants Protection Act poses a challenge to the right to abortion. Nonetheless, the legislature and the judiciary should be willing to act and have the power to mark the limit of the Born-alive Infants Protection Act. However, the enforcement guidelines of the Act fail to state the measures appropriate when the survival of the infant is not marginally viable. For this reason, it fails to specify the resuscitation options available to parents. Moreover, the neonatologists fear facing legal consequences in the event they seek to conduct procedures without any intervention (Costins, 2013). Important to note is that aggressive resuscitation leads to an increased possibility of disability and even worse may lead to death. Thus, modifications on the Act are critical to specify that resuscitation is only allowable for infants above 24 weeks’ gestation. Hence, protecting the lives of born-alive infants will be a justifiable course.
On the other hand, the Born-alive Infants Protection Act has issues when it comes to the enforcement of wills as well. Whenever a mother wishes to distribute her assets equally to her two children and in the process, she conceives other two in two live-birth abortions; then her estate proceeds will be divisible to four children. However, this may not be the case as per the intentions outlined in her will as variations have arisen and it may become problematic (Malloy, 2011). For this reason, modifications on the matters related to wills are important to avoid creating a conflict in the division of properties and assets. Regardless, the Born-alive Infants Protection Act seeks to protect children born under risky circumstances.
References
Cohen, J. (2014). Is the fraction of people ever born who are currently alive rising or falling? Demographic Research, 30, 1561-1570. http://dx.doi.org/10.4054/demres.2014.30.56
Costins, P. (2013). Refining or defining the Born Alive Rule? Women and Birth, 26, S24. http://dx.doi.org/10.1016/j.wombi.2013.08.168
Dungan, J. (2012). Resuscitation of likely nonviable infants: a cost-utility analysis after the Born-Alive Infant Protection Act. Yearbook of Obstetrics, Gynecology and Women's Health, 2012, 195-196. http://dx.doi.org/10.1016/j.yobg.2012.06.071
Malloy, M. (2011). The Born-Alive Infant Protection Act: Impact on Fetal and Live Birth Mortality. American Journal of Perinatology, 28(05), 399-404. http://dx.doi.org/10.1055/s-0031-1274507
