PEDIATRICS Vol. 70 No. 6 December 1982, pp. 955
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MEDICINE, MORALITY AND LIFE AND DEATH

Decisions to omit treatment are made daily, usually near the bedside by the medical team, the family, clergy and, in some hospitals, ethics committees. Few such decisions are contested or brought into court because they are probably as morally correct as humans can accomplish.

These decisions respond to the tensions of the competing demands on the physician to sustain life and to relieve suffering; the family's preference for life but aversion to pain; and the fear and trembling of all—fear of the ambiguities of the situation and trembling at the awesome finality of the judgment.

While I recognize some decisions on forgoing treatment must and will end up in the courts, I am opposed to general legislation on the subject or taking these questions routinely to judges for these reasons:

First, decisions taken as they are now may be as good or better than those handed down by courts.

Second, decisions at bedside conferences do not constitute judicial precedents tying the hands of future decision-makers and are not invested by state authority with an imprimatur of public policy.

I would be loath to see decisions to forgo treatment made by the book—statutory laws interpreted by reported cases and refined by rules and regulations. A complex society must have its statutes and rule-makers, but I hope we shall be spared batteries of lawyers in intensive-care units flipping through loose-leaf books to determine what is permissible. It is better to have the present system by which those most closely involved decide what seems to be right, despite all the shortcomings of such an approach.