Department of law and ethics

Abstract

With this issue we announce a change in the editorship of the Department of Law and Ethics. Because of the pressure of other professional responsibilities, Walter Probert and Ron Carson, under whose guidance this department was established, have asked to be relieved of this responsibility. We accept their request with regret, and acknowledge: with thanks the work that they have done.

We are proud to present to the readers of Death Studies the new editors of the Department of Law and Ethics, Dr. Arthur Zucker, who is just now joining the faculty of philosophy of Ohio University, and Ms. Louise Annarino, Associate Director of the Office of Legal Affairs at Ohio University. The combined experience and expertise of these two highly accomplished individuals is ideal for the editorial leadership of this important department in Death Studies.     

Department of law and ethics

This issue's Department of Law and Ethics was written by Gershon B. Grunfeld of the Department of Philosophy at the University of Tennessee, Knoxville.

The need for the use of anencephalic newborns as organ donors is raised in two distinct ways. First is the fact that there are many chronically ill infants and children who may benefit from organ transplant, while there is a relative scarcity of available donors. Second is the desire of some parents of anencephalic infants to salvage some good from a tragic situation. The prognosis for these infants is death within hours, days, or weeks from birth (2). Nevertheless, the vital organs of anencephalic infants, other than the brain, are usually normal and suitable for transplantation (3).     

Department of law and ethics

If someone discovers during routine medical studies that I have some special factors in my blood that might prove useful (and profitable) to medical researchers, then I would certainly have the right to want to be paid for the use of my factors. No one would think this odd. I might not be particularly praiseworthy, but that is another issue.     

Department of law and ethics

A lawyer representing Nancy Cruzan has filed for a hearing on the grounds that he has three witnesses who will testify that they had “specific discussions with Nancy Cruzan regarding her wishes about life-sustaining medical treatment” (1).     

Department of law and ethics

Abstract

Claire Conroy and Karen Quinlan will be forever linked by the dubious distinction of having their medical care the subject of a landmark decision from the New Jersey Supreme Court. Quinlan is well known, her high-school yearbook picture a symbol of the perplexing problems occasioned by modem medicine's power to rescue from death some who can never be aware of life. In the New Jersey Supreme Court's decision (1), Karen Quinlan's right to privacy (more accurately, her right t o determine what treatments she would receive), was held to outweigh the public's interest in the preservation of each human life. The authority to determine what Karen Quinlan would have wanted was granted to her father, and he was explicitly authorized to have her respirator discontinued once her prognosis of permanent unconsciousness was confirmed by a “hospital ethics committee”, even though her physician felt that this might well precipitate her death. The court's decision was the first time that a state's highest court acknowledged that some forms of life-sustaining medical treatment are not, from the patient's own perspective, beneficial or necessary.     

Department of law and ethics

Abstract

Elizabeth Bouvia and the California Courts are giving continuity to “Law and Ethics”. Superior Court Judge Jack Newman appointed two physicians, D. H. Catlin and D. A. Gorelick, to evaluate the differences of opinion on Ms. Bouvia's medical management. Their report said in part that she “has not received comprehensive pain control treatment and that she had not received any help in dealing with the 'psychological and social aspects of pain control'” (1). They also said that she had a poor relationship with her doctor and the staff. Given this report, Judge Newman had her removed to University of Southern California Medical Center until she could find a private facility comfortable enough with her situation to treat her as she wishes. Just as important to Bouvia, the judge ordered the physicians to continue her morphine treatment. (The doctors at High Desert had decided that she ought to be weaned from her morphine treatment.)     

Department of law and ethics

Is There a Constitutional Right to Health Care?

William Curran (1) points out that the Supreme Court has twice held that state and federal legislatures do not have legal obligations to fund abortions for the indigent. The cases were Maher v. Roe and Harris v. McRae decided respectively in 1977 and 1980 (1). In the face of these decisions, he discusses a case decided in 1987 by the U.S. Court of Appeals for the Eleventh Circuit. According to Curran, Toni Wideman, 4 months pregnant, experienced severe abdominal pain. She arranged to meet her obstetrician immediately at Piedmont Hospital and called for an emergency vehicle. Against her repeated protests, however, the ambulance took her to Shallowford Community Hospital because the county had an arrangement for emergency services with Shallowford. Mrs. Wideman waited for some time to see a doctor, who then spoke with her obstetrician over the telephone. The obstetrician requested that she be transferred to Piedmont. At Piedmont, Mrs. Wideman gave birth to a premature infant who died within hours.     

Department of law and ethics

The French government commissioned a report on which it could base laws aimed at controlling the frontiers of biomedical research. The report is entitled, “The Life Sciences and the Rights of Man.” The desirability of such a law (or laws) was made evident last year when a surgeon was accused of performing experiments on a brain dead patient. The new laws would clearly make such experimentation illegal.     

Department of law and ethics

Abstract

It is hard to fault a befuddled public for wondering, as a perceptive cartoonist recently wondered (1), whether it is not high time for a federal commission on commissions. In very recent memory, we have had reports from the Education Commission, the Hunger Commission, and the Central American (“Kissinger”) Commission. Less visible, because less politically charged, were the reports of the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, the last of which, issued in March 1983, marked the completion of that Commission's work. These documents represent a second effort at providing a national forum for public discourse about moral questions in health care and biomedical research.     

Department of law and ethics

Abstract

In early December of 1987, Britain came to some conclusions concerning issues of fertilization and embryology. In passing, they scooped the New Jersey Supreme Court finding on Baby M. The British government proposed a licensing authority to oversee fertilization and embryo research. It was suggested that Parliament be given the authority to decide on whether and how much human embryo research should be allowed.     

Department of law and ethics

Elizabeth Bouvia and the California Courts are giving continuity to “Law and Ethics”. Superior Court Judge Jack Newman appointed two physicians, D. H. Catlin and D. A. Gorelick, to evaluate the differences of opinion on Ms. Bouvia's medical management. Their report said in part that she “has not received comprehensive pain control treatment and that she had not received any help in dealing with the 'psychological and social aspects of pain control'” (1). They also said that she had a poor relationship with her doctor and the staff. Given this report, Judge Newman had her removed to University of Southern California Medical Center until she could find a private facility comfortable enough with her situation to treat her as she wishes. Just as important to Bouvia, the judge ordered the physicians to continue her morphine treatment. (The doctors at High Desert had decided that she ought to be weaned from her morphine treatment.)