[2] Keene's mother had been notified of her condition following ultrasonography,[1] and was advised to terminate the pregnancy by her obstetrician and neonatologist[3] but chose to carry the child to term because of "a firm Christian faith that all life should be protected".

[5] Fairfax Hospital doctors strongly advised a "do not resuscitate" order for the child, which the mother refused.

At trial, several experts testified that providing ventilator support to an anencephalic infant went beyond the accepted standard of medical care.

The court interpreted the Emergency Medical Treatment and Active Labor Act (EMTALA) to require continued ventilation for the infant.

Some commentators, including Arthur Kohrman and Jacob Appel, have argued that the ruling effectively undermined the right of physicians to make sound medical decisions.