Proposals criticised

Press, Volume CXV, Issue 33869, 14 June 1975, Page 21

Proposals criticised

A Government proposal to put “at risk” infants on a register in the hope that handicapping conditions would be diagnosed early has been strongly criticised by the president of the Paediatric Society of New Zealand (Professor F. T. Shannon). Professor Shannon, who is professor of paediatrics at the Christchurch Clinical School, said that recently gazetted revisions of the Obstetric Regulations provided for the establishment of two registers for newborn infants and children. The first covered children born with recognisable handicapping conditions and the regulations ensured that such children would receive continuing long-term supervision, said Professor Shannon. "This register will not only provide valuable information on the prevalence of such abnormalities but it will also indicate changing patterns. Such a register would have the support of doctors throughout New Zealand,” said Professor Shannon. “However, the second register, labelled ‘at risk’ or ‘observation.’ is open to serious objections and is the cause of concern to many paediatricians throughout the country and to my society.” Professor Shannon said that infants would be placed on the "at risk” register by using some items of medical and social information concerning the circumstances of brth and the first few days of hfe. Infants so identified would then be the subject of special scrutiny in the health department's infant supervision programme in the hope that handicapping conditions would be diagnosed early. "if such a system were effective it would have much to commend it. but experience. particularly in Fngland. has already shown that registers of this nature do not work because not enough is known about th -c tactors which can be identified at birth and which subsequently lead to handicap." said Professor Shannon “The paramount objection to such a register is that it

is certain to cause a great deal of unnecessary anxiety for the parents of infants! who are so labelled. A sug-! gestion has been made that! parents may not always be! told that their child has! been placed in the register, but this is indefensible on! ethical grounds.” The paediatric society had, set up a sub-committee of! experts in this field to con-! sider the problem and they] were unanimous that the “at: risk” factors defined in the; department’s scheme were) too vague to be useful; that] the register would not be an! effective method of impro-; ving the diagnosis of hand)-: capping conditions and that the needless anxiety pro-! duced in parents was too high a price to pay for minimal rewards. Professor Shannon said the department was prepared; to facilitate and foster the routine examination of ail’ children at regular intervals,; such as at six weeks of age and at nine months. Such a programme, properly carried out, would achieve all the objects of the “at risk” register without! needlessly categorising new-! born babies in a manner’ that had no firm basis in present medical knowledge. “If 60 per cent of all! children were put on a register only 70 per cent of handicapping conditions; would subsequently be diagnosed by the sort of followup assessment proposed, he said.

“The proposal would take a tremendous amount of medical and nursing time, time that could be much better used in other directions.”