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Stillbirth Blocks Plan for First Use of Disputed Organ Donation Policy

December 23, 1987|ROBERT STEINBROOK | Times Medical Writer

LOMA LINDA, Calif. — An Arcadia woman delivered a stillborn baby girl Tuesday, dashing her hopes that the infant's vital organs could be used for transplantion.

The parents, Brenda and Michael Winner, had known their child would be born with most of her brain missing and had touched off a controversy by expressing a desire to have the child kept alive artificially so that its major organs could be donated.

"We are all very sad to have to report to you some very sad news," Dr. Joyce Peabody said at a press conference.

Peabody, chief of neonatology at Loma Linda University Medical Center, said a team of doctors worked for six minutes trying to resuscitate the baby. "The family and my staff are very much at peace with the fact that we tried," she said.

The closely watched delivery, which took place amid medical and ethical controversy, was apparently without precedent in the United States.

Under procedures made public Friday, Loma Linda physicians had planned to sustain the child, whom the parents decided to name Jarren, on a respirator for up to seven days.

Loma Linda's procedures are controversial because some physicians and ethicists say it is unethical and inhumane--even with parental consent--to artificially keep an anencephalic baby alive, not for its own benefit, but in order to harvest its organs.

The girl was born at 3:49 p.m. with "no visible signs of life," Peabody said. A resuscitation was started immediately, as the Winners had requested.

A brief heart rate of 20 beats per minute was detected after three minutes. But at six minutes, there were no signs of life, including no heart rate and the baby was pronounced dead.

"The Winner family held their baby and said goodby," Peabody said.

Because doctors were monitoring Baby Jarren's heartbeat throughout labor, they were able to determine that her death occurred only minutes before she was born, according to Dr. Elmer P. Sakala, who performed the delivery.

During the last stages of labor, the baby's shoulders were pushed against her mother's pubic bone, which interfered with the blood supply to the baby's tissues. Despite the best obstetrical care, this is a common cause of death in anencephalics, 50% to 60% of whom are stillborn.

Despite Tuesday's setback, Peabody said, Loma Linda intends to push on with its anencephalic organ donation program. "It doesn't alter the fact that we will offer this option to parents who fully understand it," she said.

Peabody said physicians Tuesday night were still exploring the possibility of donating the child's corneas and heart valves.

Birth of the child, the couple's first, had been expected as early as Dec. 12, but the mother did not go into labor until early Tuesday.

Without life-sustaining equipment, anencephalic babies usually die within a few days of birth, but their vital organs deteriorate and cannot be used for transplants.

In October, Loma Linda's Dr. Leonard Bailey transplanted a heart from a brain-dead Canadian baby into Paul Holc, who was delivered early by Caesarean section. Paul, who was born with a fatal heart defect, is now home with his parents in Vancouver, Canada.

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