A Circumscribed Plea for Voluntary Physician‐Assisted Suicide
2000; Wiley; Volume: 913; Issue: 1 Linguagem: Inglês
10.1111/j.1749-6632.2000.tb05167.x
ISSN1749-6632
Autores Tópico(s)Medical Malpractice and Liability Issues
ResumoAnnals of the New York Academy of SciencesVolume 913, Issue 1 p. 127-149 A Circumscribed Plea for Voluntary Physician-Assisted Suicide RAPHAEL COHEN-ALMAGOR, RAPHAEL COHEN-ALMAGOR The University of Haifa, Mount Carmel, Haifa 31905, IsraelSearch for more papers by this author RAPHAEL COHEN-ALMAGOR, RAPHAEL COHEN-ALMAGOR The University of Haifa, Mount Carmel, Haifa 31905, IsraelSearch for more papers by this author First published: 25 January 2006 https://doi.org/10.1111/j.1749-6632.2000.tb05167.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat NOTES AND REFERENCES 1 Notorious among them are the Hemlock Society in the United States, and the corresponding association in Vancouver, British Columbia. Sue Rodriguez disassociated herself from the British Columbia association after she felt they used her and betrayed her trust. For further discussion see http://www.FinalExit.org/world.fed.html; e-mail: 〈[email protected]〉, and Death Net http://www.island.com/~deathnet/. In November 1999, a weekend conference was held in Seattle dealing with methods of self-deliverance from a terminal illness using new equipment. Only those with "hands-on" experience with assisting death were invited, and the conference location was kept secret. Derek Humphry, whose Euthanasia Research and Guidance Organization sponsored the two-day meeting, explained that they did not want "observers, moralists, philosophers or protesters." See the Seattle Times, http://www.seattletimes.com/news/local/html98/suic_19991115.html and http://www.finalexit.org/practice.html Google Scholar 2 Sue Rodriguez v. The Attorney General of Canada, File No. 23476 (September 1993). Google Scholar 3 Opening Motion (Tel-Aviv) 1141/1990. Benjamin Eyal v. Lichtenstaedter Hospital. P.M. 1991 (3), 194. Google Scholar 4 Fred Rosner, Modern Medicine and Jewish Law (New York: Yeshiva University Press, 1972); A. Carmi, "Live Like A King: Die Like A King," in Amnon Carmi (Ed.), Euthanasia (Berlin: Springer-Verlag, 1984), pp. 3-28; Haim David Halevi, "Disconnecting a Patient Who Has No Chance of Surviving from an Artificial Resuscitation Machine,"Tchumin (Alon Shevut, 1981), Vol. 2, pp. 297-305 [in Hebrew]. Google Scholar 5 Opening Motion (Tel-Aviv) 1141/1990. Benjamin Eyal v. Lichtenstaedter Hospital. P.M. 1991 (3), 187. For further deliberation on similar cases see 1030/95 Israel Gilad v. Soroka Medical Center and Others, Beer Sheva District Court (23 October 1995); Opening Motion 2339 + 2242/95 A.A. and Y. S. v. Kupat Holim and State of Israel, Tel Aviv District Court (11 January 1996); Opening Motion 2242/95 Eitay Arad v. Kupat Holim and State of Israel, Tel Aviv District Court (1 October 1998). Judge Talgam emphasized in the Arad case that the starting point must be the dignity of the patient, and not of the hesitant doctor. Google Scholar 6 See David Novak, Jewish Social Ethics (New York: Oxford University Press, 1992), esp. p. 17; David Novak, Jewish-Christian Dialogue (New York: Oxford University Press, 1989), pp. 8, 142-151. For a contesting view see Justice Elon in Civil Appeal 506/1988 Yael Scheffer, through Talila Scheffer v. The State of Israel, para. 20. Google Scholar 7 I thank Dr. Nachman Wilensky for showing Rabbi Lau's letter to me. Google Scholar 8 For an opposing stance see Avraham Steinberg, "The Terminally Ill-Secular and Jewish Ethical Aspects,"Israel J. Med. Sci, Vol. 30, No. 1 (January 1994), pp. 130-135, esp. 134. Google Scholar 9 "Can Life Be Evaluated? The Jewish Halachic Approach vs. the Quality of Life Approach in Medical Ethics: A Critical View" (with Merav Shmueli), Theoretical Medicine and Bioethics (2000). See also Timothy Quill, Rebecca Dresser, and Dan Brock, "The Rule of Double Effect-A Critique of Its Role in End-of-Live Decision Making,"New England Journal of Medicine, Vol. 337 (11 December l997), pp. 1768-1771. Google Scholar 10 Will Gaylin, Leon Kass, Edmund Pellegrino, and Mark Siegler, "Doctors Must Not Kill,"Journal of the American Medical Association, Vol. 259 (1988), 2139; Edmund D. Pellegrino, "Doctors Must Not Kill," in Robert I. Misbin (Ed.), Euthanasia: The Good of the Patient, the Good of Society (Frederick, MD: University Publishing Group, 1992), pp. 27-41; Charles L. Sprung, Leonid A. Eidelman, and Avraham Steinberg, "Is the Physician's Duty to the Individual Patient or to Society?,"Critical Care Medicine, Vol. 23, No. 4 (1995), pp. 618-620. For a contrasting view see Fredrick R. Abrams, "The Quality of Mercy: An Examination of The Proposition 'Doctors Must Not Kill,'"in Robert I. Misbin (Ed.), Euthanasia: The Good of the Patient, the Good of Society, op. cit., pp. 43-51. Google Scholar 11 Charles Sprung, "Changing Attitudes and Practices in Forgoing Life-sustaining Treatments,"Journal of the American Medical Association, Vol. 263, No. 16 (25 April 1990), p. 2214. Google Scholar 12 Civil Appeal 506/88 Scheffer v. The State of Israel, P.D. 48 (1) 87, at 172-173. Google Scholar 13 Sprung et al. present data showing that doctors see the CPR treatment as "useless," even when the patients' chances are 5 to 10 percent. They further note that the chances for giving such treatment drop when the patients are black, and that many life-and-death decisions are made without the consent of the patients or their family members. See Charles L. Sprung et al., "Changes in Forgoing Life-Sustaining Treatments in the United States: Concern for the Future,"Mayo Clin Proceedings, Vol. 71 (1996), pp. 512-516, at 513-514. Google Scholar 14 Interviews with Dr. George Beausmans (Maastricht, 26 July 1999), and Dr. Gerrit K. Kimsma (Koog 'aan de Zaan, 28 July 1999). Google Scholar 15 Those opposed to my view will say that the Netherlands exemplifies a state in which the defining guidelines for mercy killings are often crossed, resulting in many patients' being killed against their will. See David Orentlicher, "The Legalization of Physician Assisted Suicide: A Very Modest Revolution,"Boston College Law Review, Vol. XXXVIII, No. 3 (May 1997), pp. 459-462. Google Scholar 16 The anxiety over the slippery-slope syndrome was probably foremost in the minds of the participants of the 39th World Medical Assembly, held in Madrid in October 1987. In the World Medical Association Declaration on Euthanasia it was contended that euthanasia, "that is, the act of deliberately ending the life of a patient, even at the patient's own request or at the request of close relatives, is unethical. This does not prevent the physician from respecting the desire of a patient to allow the natural process of death to follow its course in the terminal phase of sickness." For critical discussion of the slippery-slope syndrome see R. G. Frey, "The Fear of a Slippery Slope,"in Gerald Dworkin, R.G. Frey, and Sissela Bok (Eds.), Euthanasia and Physician-Assisted Suicide (New York: Cambridge University Press, 1998), pp. 43-63; Ronald Dworkin, "When Is It Right to Die?,"The New York Times (17 May 1994), at A19; Bernard Williams, "Which Slopes Are Slippery," in Michael Lockwood (Ed.), Moral Dilemmas in Modern Medicine (Oxford: Oxford University Press, 1985), pp. 126-137. Google Scholar 17 See, for example, Yale Kamisar, "Some Non-Religious Views against Proposed "Mercy Killing Legislation'"Minnesota Law Review, Vol. 42, No. 6 (1958), pp. 969-1042; Yale Kamisar, "Against Assisted Suicide-Even a Very Limited Form,"The University of Detroit Mercy L. Review Vol. 72 (Summer 1995) pp. 736-739; Sissela Bok, "Death and Dying: Euthanasia and Sustaining Life,"Encyclopedia of Bioethics, edited by Warren T. Reich (New York: The Free Press, 1978), Vol. 1, pp. 268-267; Sissela Bok, "Euthanasia" in Gerald Dworkin et al. (Eds.), Euthanasia and Physician-Assisted Suicide, op. cit., esp. pp. 112-118; Peter A. Singer and Mark Siegler, "Ethaniasia-A Critique,"New England Journal of Medicine, Vol. 322 (June 1990), pp. 1881-1883; Charles J. Dougherty, "The Common Good, Terminal Illness and Euthanasia,"Issues in Law and Medicine, Vol. 9, No. 2 (Fall 1993), pp. 151-166; Carl Elliot, "Philosopher Assisted Suicide and Euthanasia,"BMJ, Vol. 313 (26 October, 1996), p. 1088. Google Scholar 18 See R. Cohen-Almagor, "'Muerte con dignidad', 'calidad de vida,''estado vegetativo,''doble efecto' y otras expresiones empleadas por los medicos,"Perspectivas Bioeticas, No. 5 (1998), pp. 26-44 [Spanish]. Google Scholar 19 One of Swigart and colleagues' findings on the role of families in the critical care setting is that explanations should be made in language clearly understandable to family members. They note overuse of medical terms or presentations of medical minutiae that may be overwhelming and confusing for family members. Valerie Swigart, Charles Lidz, Victoria Butterworth and Robert Arnold, "Letting Go: Family Willingness to Forgo Life Support,"Heart and Lung, Vol. 25, No. 6 (1996), p. 492. Google Scholar 20 R. Anspach, Deciding Who Lives (Berkeley: University of California Press, 1993), pp. 85-163. Quoted in Swigart et al., "Letting Go: Family Willingness to Forgo Life Support,"op. cit., p. 484. Google Scholar 21 R. Cohen-Almagor, "Some Observations on Post-Coma Unawareness Patients and on Other Forms of Unconscious Patients: Policy Proposals,"Medicine and Law, Vol. 16, No. 3 (1997), pp. 451-471. Google Scholar 22 In March 1998, Justice Antonin Scalia declared that Congress, not the Supreme Court, should decide such vexing questions as abortion rights, the death penalty, and physician-assisted suicide. Scalia said: "It is not supposed to be our judgment as to what is the socially desirable answer to all of these questions. That's supposed to be the judgment of Congress, and we do our job correctly when we apply what Congress has written as basically and honestly as possible." Glen Johnson, "Scalia: Let Congress, not court, decide abortion, assisted suicide,"The Associated Press (9 March 1998, 2:14 PM EST). http://www.nytimes.com Google Scholar 23 Songs were written about Jack Kevorkian. For instance, Detroit rocker Mitch Ryder dedicated his song "Mercy" to "Dr. Jack" Kevorkian. The lyrics are straightforward: "Cast your spell, Dr. Jack/ I am willing, I can't wait/ End my pain/ No one else/seems to understand my fate." Dr. Kevorkian himself released a CD with 12 songs, 11 of which he wrote. The liner notes say that Kevorkian wants to be remembered as a doctor who help relieve human suffering. Google Scholar 24 These are the documented cases. See http://www.finalexit.org/kevorkian.htm. I have checked this site for updates in December 1999 and then the requested URL /http://kevorkian.htm was not found on this server. Google Scholar 25 Cf. People v. Kevorkian, No. 90003196 (Oakland County, Mich., 14 December 1990); People v. Kevorkian, No. 90-390963-A2 (Oakland County, Mich., 5 February 1991); Jim Persels, "Forcing the Issue of Physician-Assisted Suicide,"Journal of Legal Medicine, Vol. 14 (1993), pp. 95-100. Google Scholar 26 Stephen Vicchio, "Death's logic" (4 April 1999), in URL: http://www.sunspot.net Google Scholar 27 Jack Kevorkian and John Doe v. Arnett, No. CV-94-6089 CBM (Kx), 939 F.Supp. 725 (11 September 1996), at 351. Google Scholar 28 State of Michigan v. Kevorkian, Michigan CirCt (Oakland City), verdict 8 March 1996. See http://www.courttv.com/verdicts/kevorkian.htm Google Scholar 29 Jack Kevorkian, Prescription: Medicide (New York: Prometheus Books, 1991), p. 222. Google Scholar 30 Ibid., p. 226. Google Scholar 31 Ibid., p.227. Google Scholar 32 2 April 1996: Pontiac, Mich: Kevorkian: Trial or witch-hunt?, from ERGO's electronic mailing list. e-mail: 〈[email protected]〉 Google Scholar 33 Orlando Sentinel Online, "Kevorkian responds to new allegations" (31 December 1997). URL: http://www.orlandosentinel.com/ Google Scholar 34 Brian Harmon, "Kevorkian: I'll put law on trial. Suicide advocate says he'll fight attempts to rein him in,"The Detroit News, Metro (1 January 1998). URL: http://det-news.com Google Scholar 35 Orlando Sentinel Online, "Kevorkian responds to new allegations" (31 December 1997). URL: http://www.orlandosentinel.com/ Google Scholar 36 Kevorkian explains his guiding rationale in his book Prescription: Medicide, especially in chapters 13 and 14. Google Scholar 37 Ibid., p. 223. Google Scholar 38 Ibid., p. 215. Google Scholar 39 Ibid. Google Scholar 40 Ibid, p. 225. Google Scholar 41 Ibid. Google Scholar 42 Compare Kevorkian's cold and detached descriptions to Quill's caring and humane train of thought in Death and Dignity, especially his depiction of the stories of Diane, Mark, Wendy and Mrs. J. There are stark differences between the two. See Tomothy E. Quill, Death and Dignity (New York: W. W. Norton, 1993), esp. pp. 9-16, 52-56, 84-91, 167-175, 177-179. Google Scholar 43 The Detroit News Metro (6 September 1997). URL: http://detnews.com/1997/metro/9709/06/09060039.htm Google Scholar 44 Kevorkian had no training to detect or to treat depression. For further discussion see Paul R. McHugh, "The Kevorkian Epidemic,"The American Scholar (Winter 1997), pp. 15-27. Google Scholar 45 "Coroner: Janet Good would have lived more than 6 months,"The Detroit News, Metro (6 September 1997), URL: http://detnews.com/1997/metro/9709/06/09060039.htm Google Scholar 46 Brian Harmon, "Critics: Kevorkian taking all comers. They claim terminal illness no longer only standard for suicides,"The Detroit News (Sunday, 1 March 1998). http://detnews.com; http://www.oregonian.com Google Scholar 47 Brian Harmon, "Paralyzed man fulfills death wish: Kevorkian assists 21-year-old hours after leaving hospital,"The Detroit News (Friday, 27 February 1998). See http://detnews.com; Free Press URL: http://www.freep.com; The Associated Press, "Kevorkian speaks out against police" (28 February 1998, 4:38 PM EST). Google Scholar 48 Brian Harmon, "Critics: Kevorkian taking all comers. They claim terminal illness no longer only standard for suicides,"The Detroit News (Sunday, 1 March 1998). See also http://www.oregonian.com Google Scholar 49 Ibid. Google Scholar 50 David Goodman, "Kevorkian has kidneys available to donate from suicide,"The Associated Press (7 June 1998). Article is available from URL: http://www.nytimes.com. See also Joe Swickard and David Crumm, "Kevorkian harvests kidneys,"The Free Press (8 June 1998) http://www.freep.com/news/extra2/index.htm Google Scholar 51 For chronology of events involving Kevorkian see http://deathnews.com/TDNHOME/kevo Google Scholar 52 Opinion Editorial, "Kevorkian's Needle,"The Detroit News (Sunday, 22 November 1998). Google Scholar 53 Derek Humphry (22 November l998), e-mail: [email protected], circulated via [email protected] Google Scholar 54 60 Minutes. Death by Doctor (22 November 1998). Google Scholar 55 URL source: Kevorkian 60 Minutes poll results, http://www.freep.com/news/extra2/kevo_poll.htm (24 November 1998). See also URL source: Killing not murder, most say, http://www.freep.com/news/extra2/qpoll24.htm. For discussion on the ethics of showing Kevorkian's killing on television see Fritz Wenzel, "Media are ripped at U of M forum on assisted-suicide coverage"The Toledo Blade (23 February 1999); Brian Murphy, "Wallace rethinks suicide episode" (23 February 1999). URL: http://www.freep.com/news/metro/qdeath23.htm Google Scholar 56 Ellen Goodman, "Kevorkian has punctured the ethical gray zone where most of us live,"Boston Globe (3 December 1998). URL: http://www.boston.com/dailyglobe2/337/oped/ Google Scholar 57 See Julie Grace, "Curtains for Dr. Death,"Time (5 April 1999), p. 50. Google Scholar 58 Associated Press report, "Kevorkian Gets 10 to 25 Years," Pontiac, Mich. (13 April 1999); New York Times (14 April 1999), p. A23. For further deliberation see http://www.freep.com/news/extra2/index.htm; and http://www.freep.com/news/extra2/qkevo14.htm Google Scholar 59 "Kevorkian Assistant helps AIDS patient die" (Monday, 19 January 1998, 6:50 AM EST), Pontiac, Michigan (Reuters). Google Scholar 60 "Reding believed hiding in Europe,"The Albuquerque Journal, New Mexico (26 January 2000). Google Scholar 61 Interview with Dr. Gerrit K. Kimsma (Koog 'aan de Zaan, 28 July 1999). Google Scholar 62 See the Dutch requirements of careful practice in John Griffiths, Alex Bood and Heleen Weyers, Euthanasia and Law in the Netherlands (Amsterdam: Amsterdam University Press, 1998), p. 66. Google Scholar 63 See, for instance, Section 7, Rights of the Terminally Ill Act (1995) (NT). Google Scholar 64 In Australia, the law required a "cooling off" period of nine days. In Oregon, the Act requires a waiting period of fifteen days. I do not wish to suggest an arbitrary time period of waiting, saying instead that the patient should state his or her wish several times "over a period of time." I concur with Miller and colleagues, who think that a fifteen-day waiting period may be highly burdensome for patients who are suffering intolerably and may preclude access to assisted death for those who request it at the point when they are imminently dying. Franklin G. Miller, Howard Brody and Timothy E. Quill, "Can Physician-Assisted Suicide Be Regulated Effectively?,"Journal of Law. Medicine & Ethics, Vol. 24 (1996), p. 226. See also Oregon Death with Dignity Act, Oregon Revised Statutes, Vol. 8, 1998 Supplement, at 982. Google Scholar 65 John Griffiths et al., Euthanasia and Law in the Netherlands, op. cit., p. 66. Google Scholar 66 Oregon Death with Dignity Act, Oregon Revised Statutes, Vol. 8, 1998 Supplement, at 980. Google Scholar 67 World Health Organization, Cancer Pain Relief and Palliative Care: Report of a WHO Expert Committee (Geneva, Switzerland: World Health Organization, 1990), at 11. Google Scholar 68 Directive 7 in The General Manager Circular, Israel Ministry of Health, no. 2/96 (31 January 1996) holds: "Doctors must concentrate their efforts on easing the pain, torment, and suffering of the patient, a subject of highest priority in medical treatment, especially where terminal patients are concerned," p. 12 [in Hebrew]. In order to institute effective consultation, new programs for the training and certification of palliative care consultants need to be developed and implemented. See Franklin G. Miller, Timothy E. Quill, Howard Brody et al, "Regulating Physician-Assisted Death,"New England Journal of Medicine, Vol. 331, No. 2 (14 July 1994), pp. 119-123; Timothy E. Quill, Bernard Lo, and Dan W. Brock, "Palliative Options of Last Resort,"JAMA, Vol. 278, No. 23 (17 December 1997), pp. 2099-2104; P. Anne Scott, "Autonomy, Power, and Control in Palliative Care,"Cambridge Quarterly of Healthcare Ethics, Vol. 8, No. 2 (1999), pp. 139-147; Janet L. Abrahm, "The Role of the Clinician in Palliative Medicine,"Medical Students JAMA (MSJAMA), Vol. 283 (5 January 2000), p. 116. URL: http://www.ama-assn.org/sci-pubs/msjama/articles/vol_283/no_1/jms90047.htm. For further discussion on making palliative care decisions for incompetent patients see Jason H.T. Karlawish, Timothy Quill and Diane E. Meier, "A Consensus-Based Approach to Providing Palliative Care to Patients Who Lack Decision-Making Capacity,"Annals of Internal Medicine, Vol. 130 (18 May 1999), pp. 835-840. Google Scholar 69 Section 7, Rights of the Terminally Ill Act (1995) (NT) Google Scholar 70 On this issue see Oregon Death with Dignity Act, Section 3: Attending Physician Responsibilities. See also Section D: Consent to Medical Treatment of The Israel Patients' Rights Law, 1992, Law Proposal 2132 (16 March 1992); The Patients' Rights Law, 1996, Israel Book of Laws, 1591 (12 May 1996), at 329-331; and The General Manager Circular, The Ministry of Health, no. 2/96 (31 January 1996), at 10-11 [in Hebrew]. Google Scholar 71 The first practical recommendation stated in The General Manager Circular, Israel Ministry of Health, no. 2/96 (31 January 1996), is that the diagnosis and evaluation that a patient's condition is "irreversible and terminal" shall be made by two independent doctors. At least one of them is required to be a head of department, p. 9 [in Hebrew]. Google Scholar 72 Oregon Death with Dignity Act, Oregon Revised Statutes, Vol. 8, 1998 Supplement, at 981-982. Google Scholar 73 John Griffiths et al., Euthanasia and Law in the Netherlands, op. cit., p. 66. Google Scholar 74 Section 7, Rights of the Terminally Ill Act (1995) (NT). Google Scholar 75 This Guideline is somewhat similar to the guidelines of the Swiss exit protocol. See South Australian Voluntary Euthanasia Society, Did you know? Assisted Suicide in Switzerland-saves Fact Sheet No. 20, issued February 1997. Correspondence with: Hon. Secretary, saves, PO Box 2151, Kent Town, SA 5071, Australia-Fax + 61 8 8265 2287. URL: http://www.finalexit.org/ Google Scholar 76 Andrew L. Plattner, "Australia's Northern Territory: The first Jurisdiction to Legislate Voluntary Euthanasia, and the First to Repeal It,"De Paul Journal of Health Care Law, Vol. I (Spring 1997), p. 648. Google Scholar 77 13 Or. Rev. Stat. § 3.07 (1998). Google Scholar 78 See Arthur E. Chin, Katrina Hedberg, Grant K. Higginson and David W. Fleming, "Legalized Physician-Assisted Suicide in Oregon: The First Year's Experience,"New England Journal of Medicine, Vol. 340, No. 7 (18 February 1999), pp. 577-583; Melinda A. Lee, Heidi D. Nelson, Virginia P. Tilden et al., "Legalizing Assisted Suicide-Views of Physicians in Oregon,"New England Journal of Medicine, Vol. 334, No. 5 (1 February 1996), pp. 310-315. See also http://www.ohd.hr.state.or.us/cdpe/chs/pas/pas.htm Google Scholar 79 For further deliberation see the Dutch guidelines in John Griffiths et al., Euthanasia and Law in the Netherlands, op. cit., p. 66; Oregon Death with Dignity Act, Oregon Revised Statutes, Vol. 8, 1998 Supplement, Section 3, at 983. Rebecca Cook pointed out to me that such a bureaucratic procedure might discriminate against minorities who will not find it easy to cope with the described demands. However, the demand for detailed documentation is meant to prevent abuse, not to discourage people from getting the help they want. We should be sensitive to cultural differences and strive to meet special needs that arise from cultural norms, but not at the expense of opening the door wide for "eliminating" unwanted people. Google Scholar 80 Directive 6 in The General Manager Circular, Israel Ministry of Health, no. 2/96 (31 January 1996) states: "The decision to respect a patient's objection to a life-prolonging treatment shall be documented in the medical statutes, expressing maximum reasons for the decision and the discussions with the patient," p. 12 [in Hebrew]. See also Israel Patients' Rights Law (1996), 1591, Chapter E: medical documentation and medical information, p. 331. Google Scholar 81 Andrew L. Plattner, "Australia's Northern Territory: The First Jurisdiction to Legislate Voluntary Euthanasia, and the First to Repeal It,"op. cit., p. 648. Google Scholar 82 506/88 Scheffer v. The State of Israel, Vol. 48 (1) 87, paragraph 7 of Ariel J.'s opinion (198-199). Google Scholar 83 506/88 Scheffer v. The State of Israel, Vol. 48 (1) 87, paragraph 65 of Elon J.'s opinion. For further discussion on incompetent patients and minors see Edmund D. Pellegrino and David C. Thomasma, For the Patient's Good (New York: Oxford University Press, 1988), pp. 148-161; Winifred J. Pinch and Margaret L. Spielman, "The Parents' Perspective: Ethical Decision-Making in Neonatal Intensive Care,"Journal of Advanced Nursing, Vol. 15 (1990), pp. 712-719; American Academy of Pediatrics Committee on Bioethics, "Guidelines on Forgoing Life-Sustaining Medical Treatment,"Pediatrics, Vol. 93, No. 3 (March 1994), pp. 532-536; S. Saigal, B.L. Stoskopf and D. Feeny, "Differences in Preferences for Neonatal Outcomes among Healthcare Professionals, Parents, and Adolescents,"JAMA, Vol. 281, No. 21 (2 June 1999), pp. 1991-1997; Norman Fost, "Decisions Regarding Treatment of Seriously Ill Newborns,"JAMA, Vol. 281, No. 21 (2 June 1999), pp. 2041-2043. Google Scholar Volume913, Issue1MEDICAL ETHICS AT THE DAWN OF THE 21ST CENTURYSeptember 2000Pages 127-149 ReferencesRelatedInformation
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