OF TELEVISION AND TRANSPLANTS An infant's life is saved, but TV's role raises questions of fairness

By Claudia Wallis.

It was perhaps the television coup of the season. Live on the Phil Donahue show last Tuesday, a call was placed to Butterworth Hospital in Grand Rapids. Looking on were Donahue's guests for the day: the parents of a California infant known as Baby Jesse, who desperately needed a heart transplant. A spokeswoman for the hospital got on the line and was persuaded to reveal the impossibly good news: ''We are donating a heart to the baby,'' she declared. The cameras closed in on Jesse's stunned parents as they broke into cries of joy, smiles and tears. The audience went wild. For a moment it seemed that television itself had brought about this triumphant turn of events. And in a way, it had. A week earlier the case of Baby Jesse had become a cause celebre, when officials at Loma Linda University Medical Center, 60 miles east of Los Angeles, had refused to consider the infant as a candidate for transplant. The hospital had apparently concluded that Jesse's young, unwed parents--Deana Binkley, 17, and Jesse Sepulveda, 26, of Pasadena--were incapable of providing him with the exhaustive care he would require after surgery. The infant had been born with a rare, fatal condition called hypoplastic left-heart syndrome, in which the heart's main pumping chamber is improperly developed. Without a transplant at Loma Linda, the only institution in the area that performs such surgery on infants, doctors said Jesse would die in a matter of weeks. The impending tragedy had the makings of a front-page story, which it quickly became. With help from a family priest and a local right-to-life group, a press conference was arranged that brought instant national attention to Jesse's plight. ''We had an outrageous violation of civil rights here,'' charged Right-to-Life Spokeswoman Susan Carpenter McMillan. The resulting outcry led Loma Linda to make a deal: if Jesse's parents surrendered custody to his grandparents, he would become eligible for surgery. Though Jesse ultimately got a heart, the hospital's initial rejection sparked a heated debate on how to evaluate transplant candidates. The dearth of donor organs in the U.S. often forces doctors to select one patient over another. Usually the choice is made solely on the basis of medical need, but, says David Rothman, professor of society and medicine at Columbia University, ''social criteria sometimes enter in.'' Few hospitals, he notes, will offer a liver to an unrecovered alcoholic or a heart to an inveterate smoker.

When the patient is a child, the ability of parents to provide care becomes relevant. Young transplant recipients require constant monitoring for rejection, lifelong medication and special precautions to avoid infection. For these reasons, says Ethicist Arthur Caplan of the Hastings Center at Hastings- on-Hudson, N.Y., Loma Linda officials ''were definitely right in considering ) whether the family can monitor and care for the baby effectively.'' Jesse's surgeon, Leonard Bailey, also defended the hospital. ''You can't serve up hearts like cherries jubilee,'' he exclaimed. ''The family has to be very dependable and constant.'' While Loma Linda refused to reveal the precise nature of its objections to Jesse's parents, TIME learned last week that Sepulveda has a record of arrests for drunk driving, and had been through a ''substance abuse'' treatment program. Though he downplays these problems, Sepulveda says, ''I do think that Loma Linda had good reasons to turn us down.'' Another ethical issue was brought to light by the Baby Jesse case: the growing role of the media in determining who gets organs. Frank Clemenshaw, 22, and Deborah Walters, 33, the Michigan couple who donated their baby's heart to Jesse, admitted they had been moved to do so by televised reports on Jesse and his parents. ''Our baby could not live,'' said Walters, whose son was brain-dead at birth. ''We'd seen their plea on TV, and we figured that if our baby could help them, then it would not be a total loss.'' But what television had failed to reveal was that an infant in Louisville had been waiting even longer for a heart. The parents of Baby Calvin had elected to work quietly through organ-procurement networks rather than seek publicity for their child. Upset that their baby, who should have had priority, had been passed over for the celebrated Jesse, they issued a statement last week asking Congress to ''do everything possible to see that an improved system is set up to identify donors of organs.'' At present, they charged, ''it almost seems like publicity is the only method that's working.'' In fact, Congress has already taken action to improve the organ distribution system. In 1984 it passed legislation creating a national computer bank to match organ donors to recipients. But the Reagan Administration has resisted spending the $2 million allocated for the network. Last week Senator Albert Gore, a sponsor of the legislation, blasted the Administration for dragging its feet. ''What do we tell families,'' he asked, ''that they have to go on the Phil Donahue show?'' At week's end there were happy endings in both Loma Linda and Louisville. Jesse's new heart was beating normally, and he was taken off a respirator. Baby Calvin had meanwhile found a donor, and was in stable condition following surgery. But both infants faced a long and uncertain road ahead. So far, the ; longest any infant has survived with a neonatal heart is seven months, and last week two babies who had received transplants in April at Loma Linda were back in the hospital for rejection problems. The mother of one of the infants had a word of warning to the other parents: ''It's easy to put a heart in. It's hard to keep it there.''

With reporting by Jonathan Beaty/Los Angeles and Barbara Dolan/Chicago