From whom the bell tolls: the emerging decision-makers for life-support systems in choices of who shall live and who shall die.
In summary, how do we assess these decision-makers, with their wide variations in composition, emerging today from medical technology and advances unknown and unforeseen by earlier practitioners? At the threshold, we should not dismiss lightly the traditional role of the doctor as the autocrat. There is much to be said in his or her favor: 1. The basic decision, after all, is a medical one--diagnosis and prognosis--with the concurrence perhaps of a consultant or a specialist. That decision was and is a major premise. Miss it and one misses the mark. 2. What is so novel, what is so startling about a fateful life-death issue in the medical profession? It is quotidian. In the Armageddon between human life and human demise, doctors have been making those solemn decisions in other areas of medicine from time immemorial. Often--not always--the patient is silently saying to the doctor, "My life is in your hands." 3. And within what context does he act? Usually--not always--he knows the patient. He knows the family. He knows the surrounding circumstances. But there still lurks that gnawing, underlying flaw. The decision-making is not diffused. The doctor stands alone. Small "groups" or "committees," retaining medical guidance, share responsibilities, make more palatable to themselves those agonizing decisions, and contribute to their acceptability by society. Here, then, is the harvest to be reaped by diffusion. What is so striking is that the decision-making process anent life-support systems still calls for a superior breed of men and women.(ABSTRACT TRUNCATED AT 250 WORDS)
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D003657:Decision Making; D004992:Ethics, Medical; D005060:Europe; D005065:Euthanasia; D005066:Euthanasia, Passive; D006801:Humans; D007564:Japan; D008020:Life Support Care; D014342:Truth Disclosure; D014481:United States