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Justified in Refusing to Operate on Baby, but Is Faulty in Diagnosis

Dr. Harry J. Haiselden was vindicated but at the same time inferentially criticized, yesterday.

A coroner's jury, composed of six leading physicians and surgeons, declared the chief of staff of the German-American hospital was "morally and ethically" within his rights in refusing to perform an operation which would have saved the life of Allan J. Bollinger, a deformed baby.

The vindication was not without its bitter sting. The jury declared it found no evidence that Baby Bollinger would have become mentally or morally defective, as Dr. Haiselden believed. It expressed the belief that the infant's physical defects might have yielded in a measure to plastic treatment.

The vindication of Dr. Haiselden was set forth in these words in the verdict:

We believe that, morally and ethically, a surgeon is fully within his rights in refusing to perform any operation which his conscience will not sanction. We find no reason to believe that the parents of Allan J. Bollinger were deprived of the privilege of consultation.

The rebuke which the vindication carried was pointed by the following recommendations.

We recommend strongly that in all doubtful cases of this character a consultation of two or more surgeons of known reputation for skill, ethical standing and broad experience should decide upon the advisability or inadvisability of operative measures.

Though the verdict sustains Dr. Haiselden as "morally and ethically" right, the document closes with these significant words:

We believe that the physician's highest duty is to relieve suffering and to save or prolong life.

Dr. Ludwig Hektoen, professor of pathology in Rush Medical college of the University of Chicago, was foreman of the jury. The other members were: Dr. Howard Chislett, dean of Hahnemann college; Dr. Henry F. Lewis, head of the obstetrical department of Cook county hospital; Dr. D. A. K. Steele, dean of the Physicians and Surgeons Medical college of the University of Illinois; Dr. Arthur Rankin, professor of anatomy of Loyola university; and Dr. John F. Golden, associate of Dr. J. B. Murphy at Mercy hospital.

In its verdict the jury also found that death came to the child from a cloture of the end of the intestines. Aside from this defect the jury found as follows:

"A fusion of the two kidneys into one located on the left side, absence of the right external ear and of the external auditory canal; a defective development of the skin over the shoulders, especially the right, causing an apparent shortening of the neck; absence of all or part of the coccyx.

The acquired pathological conditions are: Small extradural hemorrhages in the spinal canal; small subplural hemorrhages; and the coroner's physician reports an area of hemorrhage in the pia matter in the left Sylvian fissure.

"We believe that a prompt operation would have prolonged and perhaps saved the life of the child.

"We find no evidence from the physical defects that the child would have become mentally or morally defective.

"Several of the physical defects might have been improved by plastic operations."

After reading the verdict Dr. Haiselden said:

"I believe the jurors acted conscientiously. I know them all to be of the highest professional attainment, and profound knowledge. Two of them have been respected teachers of mine and their believing that I was technically and morally within my rights in refusing to perform an operation on the child fills me with an intense feeling of gratification. I believe that their finding has fully vindicated my position.

"I thoroughly agree that in all doubtful cases of this character a consultation of more than two surgeons of know reputation should be called. The jury has understated rather than overstated the requirements which I believe to be right and just.

"My entire training and religious belief teaches me that a physician's highest duty is to relieve suffering, but not necessarily to prolong a life which will be a burden to the poor suffering individual. I have advised against operations in cases of advanced cancer of the intestines in which I was morally certain I could prolong life but only at the expense of horrible suffering."

The physician took exception to the jury's expression of belief that a prompt operation could have prolonged the life of the child. He said he believed the application of an anaesthetic would have resulted in death. He also differed with the jurors as to the mental condition of the child and pointed out the pathological report of Dr. Zell in which it was stated that the child's brain had been softened by degenerative processes.

From "inside" sources THE TRIBUNE obtained an account of the secret deliberations which occupied the jury more than two hours before the formal verdict was given out.

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Opinion developed at this conference included:

While Dr. Haiselden's motives were correct and should not be condemned, his judgment was not that of the members of the jury.

The Bollinger baby had from an even to a three to one chance of surviving an operation for its one vital defect and should have been given that chance.

The verdict is an adverse one and is so intended.

"The brain was all right, as far as we could tell," one juror said. "There was no physical evidence that he child would have grown up mentally or morally oblique.

"It is probable that in time the head could have been separated from the shoulder by well established methods of grafting. The defect in the kidneys was not vital; many people live to old age with such a defective kidney."

The verdict came at the end of testimony of a startling character. Dr. Haiselden, stung by criticism from Dr. John Dill Robertson, interrupted the commissioner of health to say that from information in his hands he believed babies are allowed to die by physicians secretly at least "one a day" in Chicago. This statement was uncontradicted.

Dr. Robertson, in reply to a question by Dr. Haiselden, admitted that such deaths as Baby Bollinger's had happened in the city "many times before."

Dr. Haiselden took occasion in defending his position to rake Christian Science. When Coroner Hoffman asked him if he did not think it would be dangerous for physicians to determine whether babies should live or die, Dr. Haiselden answered:

"As long as we in Chicago allow the Eddyites the right not to call in a physician, then it is right for a physician to decide upon the advisability or inadvisability of operating.

"The Eddyites are allowed to control their patients until they die. No physician is allowed to see the patients. Yet burial permits are issued. As long as a religious sect is permitted to do these things by law, then I hold that I as a trained physician should be permitted to use my own judgment at all times."

Dr. Haiselden also took a fling at the prevalence of abortion in Chicago.

"Chicago allows abortion to occur daily," he said "and it is not crime so long as the woman does not die. I can point out men and women who perform abortion constantly. I can't 'get the goods' on them. But nothing, it seems, can be done to stop this terrible practice. I know ten or fifteen women who perform abortions every day."

In this amazing statement Coroner Hoffman concurred.

"Up to 1905," the coroner said, "there was not a single conviction in Chicago for abortion. Since that time, seven or eight physicians and midwives have been sent to the penitentiary. But even at present it is almost impossible to obtain evidence which will bring about convictions in such cases."

"Is there any law to compel you to operate to save the life of a child you believe mentally subnormal?" the coroner asked Dr. Haiselden.

"None," replied Dr. Haiselden. "If I had been solely in charge of this case I might possibly be amenable to prosecution for malpractice or criminal neglect. But, according to my conscience, I should have been guilty of a graver crime if I had saved this child's life. My crime would have been keeping in existence one of nature's cruelest blunders."

"What do you mean by that?" asked Dr. Lewis.

"Exactly that," retorted Dr. Haiselden. "I do not think this child would have grown up to be a mental defective. I know it."

"If you had another such case would you let the baby die?" asked Dr. Steele.

"If I am not jailed for this one I would do the same as I have done."

"If you are jailed, what then?" cut in Dr. Rankin.

"I might try to avoid punishment a second time. The burned child shuns the fire. I might let the state take the burden of its defective children if it wanted it."

A touch of drama was added to the coldly scientific tone of the inquest by Miss Catherine Walsh of 4345 West End avenue, who testified over the blunt protest of Dr. Haiselden, who called her a "wild eyed, interfering, hysterical woman," who had tried to kidnap the baby. Miss Walsh insisted on making a statement to the jury and the jurors voted with some show of eagerness to hear her.

"I went to the hospital," said Miss Walsh, "to beg that the child be taken to its mother. It was condemned to death, and I knew its mother would be its most merciful judge. I found the baby alone in a bare room, absolutely nude, its cheek numb from lying in one position, not paralyzed.

"I sent for Dr. Haiselden and pleaded with him not to take the infant's bloom on his head.

"It was not a monster -- that child. It was a beautiful baby. I saw no deformities. I patted him. Both his eyes were open, he waved his little fists and cried lustily. I kissed his forehead. I knew if its mother got her eyes on it she would love it and never permit it to be left to die.

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"If the poor little darling has one chance in 1,000,' I said to Dr. Haiselden, 'won't you operate and save it?'

"The doctor laughed. 'I'm afraid it might get well,' he replied.

"As I left the hospital a man said to me. 'I guess the doctor is right from a scientific standpoint. But humanly he is wrong.' 'Thank God,' I answered, 'we are all human.'

"I have so much faith in mothers and in the eternal feminine that I know if the baby's mother ever had been given a chance to see it it would be alive today. Any mother would have loved it."

Health Commissioner John Dill Robertson appeared as the most caustic critic of Dr. Haiselden among the witnesses.

"I went to the hospital the day the baby died," said Dr. Robertson. "I told Dr. Haiselden I did not agree wit him that the child would grow up a mental defective. I thought the child would grow up a mental defective. I thought the child was in a dying condition, and I had doubts that an operation then would save it. Yet I believed it had one chance in 100,000, and I advised Dr. Haiselden to give it this one chance.

"If it had been my case I certainly would have operated. However, I was impressed that Dr. Haiselden was acting according to his convictions. He believed he was right in letting the child die."

"Do you believe Dr. Haiselden was within the law?" asked Coroner Hoffman.

"I am not a lawyer," replied Dr. Robertson. "But I believe a doctor has the right to act on his own judgment and conscience."

"Is there any law to compel a doctor to operate in such cases?"

"None. But I think it very wrong not to save life, let that life be what it may. That is the function of a physician. I believe this baby might have grown up to be an average man. I found no evidence to contravert such a conclusion. I would have operated and saved this baby's life, however, even though I knew it was not mentally sound.

"As commissioner of health, whose duty it is to conserve the health of Chicago," Dr. Robertson added impressively, "I believe that if Dr. Haiselden's action were permitted to stand as an unchallenged precedent it would be the cause of many crimes. Many babies would be killed by unscrupulous physicians as a result.

"If our civilization has reached a stage where the life or death of infants is to be determined on the ground of fitness, then, like the ancient Spartans, we should establish a legal tribunal to pass upon the babies that are to live and those that are to be exposed to death."

If Dr. Robertson was Dr. Haiselden's severest critic, Dr. Carl A. Zell was his best defender.

"I examined the baby's brain after it was removed at the postmortem," said Dr. Zell. "It was very soft. The softening was due to degeneration of the nerve tissues. I think fatty degeneration had set in. Undoubtedly the child would have grown up mentally defective."

Dr. W. H. Burmeister, coroner's physician, on the other hand, was not convinced the baby would have become a mental defective.

The testimony of Dr. Climena Serviss of 803 Sheridan road, Mrs. Bollinger's physician, was colored with pathos and human interest.

"I attended Mrs. Bollinger at the birth of all her children," said Dr. Serviss. "This last was the fourth. At its delivery the thought flashed through my mind, 'Is this child an imbecile?' The mother knew by my expression something was wrong. I telephoned the father. He hurried to the hospital. I showed him the child. 'Dr. Serviss,' he said with trembling voice, 'must this child live?' 'It can't live without an operation,' I told him. 'Don't operate,' he said. 'It is so deformed. It will kill Anna.'

"I then went to the mother. She was calling for her baby. 'Mrs. Bollinger,' I said, 'you have a deformed child.' 'I knew it,' she returned, 'as soon as I looked at you. You have always been so happy when you brought my other children into the world and they are all perfect. This baby must not live. Please don't let my baby live to suffer.'

"After a consultation with Dr. Haiselden," Dr. Serviss concluded, "we decided not to operate to save the baby's life."