1. BABY BOLLINGER
In 1915, just before Thanksgiving, a baby was born without a neck, with only one ear, with a misshapen chest and misshapen shoulders, and with serious internal malformations. The doctor who delivered the baby at Chicago's German-American Hospital called in Dr. Harry Haiselden, a surgeon, to examine the baby. Haiselden concluded that this "defective" baby's life would not be worth saving. He convinced the parents, Anna and Allen Bollinger, to let their son die rather than embark on a series of operations to repair some of the baby's physical deformities.
This was the Bollingers' fourth child. The other three were healthy. Haiselden told the Bollingers, among other things, that the baby would "be an imbecile and possibly criminal." The Bollingers' son died when he was six days old.
The cause of the baby's deformities was unclear. Haiselden speculated that Mrs. Bollinger's bout with typhoid fever shortly before she became pregnant might have been a contributing factor. But this was just one possibility.
Baby Bollinger was one of a number of babies whose deaths were "managed" by Haiselden. At first, Haiselden would let deformed babies die, but as time went on he would abet the process by injecting the babies with narcotics. He did not hide his role in these deaths. In fact, he wrote newspaper articles about the babies, gave lectures, brought reporters to the hospital to have a look at the dying newborns, and eventually wrote a filmscript for a full length silent film?called The Black Stork?in which he publicized and glamorized his role in the deaths of the babies. No actor was hired to portray Haiselden; he chose to portray himself.
Haiselden was a vocal promoter of "euthanasia." He also was enthusiastic about the
eu = good thanatos = death
science of "eugenics" or good heredity. He had many supporters who thought, as he did, that the infants and the broader society would be better off without "defective" individuals. Helen Keller was one of Haiselden's supporters. Although she was a strong advocate for the handicapped (her own remarkable, heroic life is well known from books and the movie The Miracle Worker), Keller's position was that "a human life is sacred only when it may be of some use to itself and to the world."
Haiselden got into a certain amount of trouble for what he did, but he got into more trouble for bragging about it and broadcasting his activities. Eventually, he was ousted from the Chicago Medical Society.
- The Black Stork, Martin S. Pernick, Oxford University Press, NY, 1996.
- New York Medical Journal 1915, 102:1132-1134;1149-1152.
- JAMA 1915, LXV(23):2025.
- Which Babies Shall Live? T.H. Murray and A.L. Caplan, eds., Humana Press, NJ, 1985. Kett/Steinfels:23-45.
- Issues in Law and Medicine 1986, 1(5):345-361.
- Hastings Center Report 1997, 27(2):43.
- Hastings Center Report 1988 Aug/Sep:14-17.
Students should understand the following:
- Positions and roles of the various players (the doctors, the parents, the medical institution, the government, the media) in the decision-making process
- Difficulties in defining "normal" and "abnormal"
- Importance of language and the connotations of words to social thought
- Importance of the historical context of this case
- Concept of eugenics
- Concept of euthanasia
- Evolution of the eugenics movement in the United States and elsewhere
Suggested questions for discussion
- Who do you think should decide whether a life is worth living?parents or other family members, doctors or other medical personnel, committees, the wider community? Are laws needed?
- Would the answers to these questions be different today from the answers given in 1915 or at other time periods? What social factors have affected these answers?
- Do you think there is a difference between allowing a deformed infant to die and giving it narcotics to speed its death? Is one approach more sound or more fair than the other?
- Should the cost to society of providing for a child like Baby Bollinger be a consideration when decisions are being made about the baby's future?
- Who do you think should speak for a baby?
- Does the duty to preserve life include all lives or only certain lives? If you think the latter, what categories of lives do you think should be preserved? Which should be excluded?
- Is there a difference between a physical handicap and a mental handicap in establishing that a life is worth preserving?
- Is it possible to say that people with certain diseases (genetic or other types) should not be allowed to live? (Note: People who have certain genetic diseases worry that, if gene therapy were ever to become routine such that disease genes can be fixed, the society might conclude that no one else should be born with their particular disease. They feel that this diminishes the values of their lives.)
- The Commissioner of Health in Chicago opposed Haiselden's decision, and he expressed his concerns in a paper shortly after the baby died (reference 3 above). Should the Commissioner or others have been included in the decision-making process at the start?
- Some cultures look on the birth of a deformed child as an omen, either for good or for ill. How do such beliefs affect the treatment of deformed babies in those cultures?
- The killing of newborns?infanticide?has a long tradition. Attitudes about it vary greatly. In some cultures, children of one gender are favored. Sometimes children are killed if there are too many in a family. Sometimes those who do not appear to be physically perfect are killed. What were the practices of ancient societies toward infanticide? What about various contemporary societies?
- Articles written at the time of the Bollinger case used words like "monster" and "defective" to describe the baby. How does the use of disparaging words affect the way a culture thinks about and ultimately treats individuals?
Topics for discussion/written assessment
- What criteria could or should be used to evaluate the care and resource allocation for severely disabled babies? How do these criteria reflect religious attitudes, the equal protection clause of the 14th amendment, and political realities of interest groups who play significant roles in the election process?
- Babies cannot express autonomous views. What criteria should be used to ensure that they and other citizens who cannot speak on their own behalf still have a "voice" when decisions are made as to appropriate treatments for them?
- What roles do cultural factors play in health care decisions that are made about babies? Illustrate your position with examples from a specific culture that is not American in origin but is now found in the United States.
- By 1928, 1300 silent films had been made on medical topics. Many of them had to do with improving the species, assessing fitness for marriage and reproduction, and so on. Bollinger thus was not alone. Find out more about the eugenics and euthanasia movements in this country and in other countries throughout the 20th century. How did attitudes change over the years?
Extension questions for further investigation
- Evaluate the reasoning of Haiselden, the Bollingers, and other individuals who were involved in this case.
- Compare the views of Haiselden with the views expressed by the defendants in the cases of Vacco v. Quill and Washington v. Glucksberg, two Supreme Court decisions about physician assisted suicide that were handed down in 1997.
- Compare and contrast the viewpoints expressed about the care and "place" of severely disabled babies by supporters of the Americans With Disabilities Act with the perspectives and proposals of William Shockley and Arthur Jensen.
Topics for teacher preparation
- Birth deformities
- Language and how its use affects thinking and behavior