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This article will both explore and thereby establish the medical, ethical, and legal validity of selective nontreatment of severely handicapped newborns. A construct for principled decision-making, tied to a basic recognition of the right of self-determination, as shaped by compassion and validated principles of triage and cost-benefit analysis, will be seen as the most effective means for the states-and not the federal government-to evaluate the intensely complex issues associated with allocating scarce medical resources to defective infants. Governmental intrusions into the familial decision- making forum in these circumstances must be kept to a minimum and allowed only in grave cases.



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