The Baby Fae Case

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Recommended: applying medical ethical principles

The Baby Fae Case

The issues surrounding the Baby Fae case raised some important questions concerning medical ethics. Questions were raised regarding human experimentation (especially experimentation in children), risk/benefit ratio, the quality of informed consent, and surrogate decision-making. Primarily, this case showed that new guidelines were needed to regulate radical procedures that offer little hope and high notoriety and recognition of the physician performing them. Dr. Bailey had been doing extensive research for years on xenografts, or cross-species transplantations, yet none of his animal recipients had survived over 6 months.16 His research was neither governmentally funded nor available for peer-review, and Dr. Bailey was even warned by colleagues that his procedure was not ready for human patients. Previous primate xenografts had been tried with humans, but all had been rapidly rejected.

Dr. Bailey claimed that since the recipient was an infant, her immune system was not developed enough to reject the transplant.16 However, immunologists stated that the immune system is developed enough by birth to reject transplantation. Also, since baboons have no antigens in common with human tissue, there is no way the procedure would be successful. Despite these findings, Dr. Bailey told the parents that the transplantation would offer the baby a hope for life and possible long-term survival.16 Finally, when Dr. Bailey was questioned by the Times of London, he stated that he does not believe in evolution so that the evolutionary distance between a baboon and human had not gone into his decision making process when choosing a donor. Dr. Bailey had not looked for a human heart donor nor did he do a ref...

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...ing. Moreover, if a treatment has the possibility of curing a child, but is unproven, even parents (who are eager to prolong the life of their children but lack the technical expertise to properly assess the risks involved) are not permitted to consent to it. Furthermore, Munson proposes that the IRB should be required to include outside experts to assess risks and benefits of experimental treatments.15

Overall, the Baby Fae case raised many important issues that should be considered. It has profound, albeit uncertain, implications for the future of medical ethics, professional standards, and legal applications. One thing is for sure, nothing of scientific or medical value came from the transplant. Bailey never did the four additional primate-to-human heart transplants that the IRB allowed him. Moreover, no one else has performed such a transplant since.15

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