PDF1 - University of Maryland School of Law

persons to achieve their maximum potential throughincreased independence, productivity, and integrationinto the community"; and the ArchitecturalBarriers Act of 1968 115 is intended to make publicbuildings physically accessible to people with disabilities.116It is the interpretation of the Department ofHealth and Human Services, the Federal agencycharged with implementing the Child AbuseAmendments of 1984, that "the law [does] notpermit life and death treatment decisions to be madeon the basis of subjective opinions regarding thefuture 'quality of life' of a retarded or disabledperson." 117 Before passage of the Child AbuseAmendments, nine major disability and medicalassociations adopted a set of "Principles of Treatment"that also rejected the use of quality of lifecriteria: "Considerations such as anticipated oractual limited potential of an individual and presentor future lack of available community resources areirrelevant and must not determine the decisionsconcerning medical care." 118ConclusionThe bases typically advanced to support denial oflifesaving medical treatment, food, and fluids basedon disability—that the quality of life of a person witha disability will be unacceptably poor, or that such aperson's continued existence will impose an unacceptableburden on his family or on the Nation as awhole—are often grounded in misinformation, inaccuratestereotypes, and negative attitudes aboutpeople with disabilities. A country committed to thecivil rights of all should address the very realproblems people with disabilities and their familiesface through fostering supportive services and socialacceptance, and through defending their rights toaccessible and integrated transportation, housing,education, health care, and employment—not byeliminating those with disabilities.11542 U.S.C.A. §§4151 to 4157 (West 1977 & Supp. 1988).nsSee generally U.S. Commission on Civil Rights, Accommodatingthe Spectrum of Individual Abilities 46-62 (1983).117Child Abuse and Neglect Prevention and Treatment Program,50 Fed. Reg. 14878, 14879 (1985). See also id. at 14880; 45C.F.R. pt. 1340 App. Interpretative Guideline 9 (1987); chap. 7.118Joint Policy Statement: Principles of Treatment of DisabledInfants, 73 Pediatrics 559, 559 (1984). The cosigning organizationswere the Association for Retarded Citizens, the National Down'sSyndrome Congress, the American Coalition of Citizens withDisabilities, Inc., the Association for Persons with SevereHandicaps, the American Association on Mental Deficiency, theAmerican Association of University Affiliated Programs forPersons with Developmental Disabilities, the Spina Bifida Associationof America, the National Association of Children's Hospitalsand Related Institutions, Inc., and the American Academy ofPediatrics. However, the American Academy of Pediatrics hassince argued, with regard to the Child Abuse Amendments, thatCongress did not "clearly intendQ to exclude consideration of theinfant's quality of life." Comment of the American Academy ofPediatrics on Proposed Rules Regarding Child Abuse NeglectPrevention and Treatment Program 30 (Feb. 8, 1985), quoted inNicholson, Horowitz & Parry, Model Procedures for ChildProtective Service Agencies Responding to Reports of WithholdingMedically Indicated Treatment from Disabled Infants With Life-Threatening Conditions, 10 Mental & Physical Disability L. Rep.220, 227 (1986).47