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Hastings Center Report
Volumn 24, Issue 1, 1994, Pages 33-42
Profoundly Diminished Life: The Casualties of Coercion
Author keywords

[No Author keywords available]
Indexed keywords

SUFFERING;
EID: 0028247790     PISSN: 00930334     EISSN: 1552146X     Source Type: Journal    
DOI: 10.2307/3562386     Document Type: Article
Times cited : (44)
References (31)
  • 1
    • 0025820606 scopus 로고
    • “A New Kind of ‘Right to Die’ Case,”
    • Steven H. Miles, “Informed Demand for ‘Non‐Beneficial’ Medical Treatment,” NEJM 325 (1991): 512‐15
    • (1991) NEJM , vol.325 , pp. 511-512
    • Angell1
  • 2
    • 0347585650 scopus 로고
    • “A Question of Letting Go: Child's Trauma Drives Doctors to Re‐examine Ethical Roles,”
    • “While Child Suffered, Beliefs Clashed, Washington Post, 15 July 1991. In this case the patient died before legal action could be commenced.
    • (1991) Washington Post
    • Weiser, B.1
  • 3
    • 84977730987 scopus 로고
    • “Informed Demand”; Tom Tomlinson and Howard Brody, “Futility and the Ethics of Resuscitation,”
    • Lawrence J. Schneiderman, Nancy S. Jecker, and Albert R. Jonsen, “Medical Futility: Its Meaning and Ethical Implications,” Annals of Internal Medicine 112 (1990): 949‐54
    • (1990) JAMA , vol.264 , pp. 1276-1280
    • Miles1
  • 5
    • 0027633739 scopus 로고
    • “Terra es Animata: On Having a Life,”
    • Standing with them, to varying degrees, are those who think that human personhood is inherent in a person's entire biological history, not just the capacity for consciousness and cognition. See, for example
    • (1993) Hastings Center Report , vol.23 , Issue.4 , pp. 25-32
    • Meilaender1
  • 6
    • 0023795052 scopus 로고
    • “Who Defines Futility?”
    • Schneiderman, Jecker, and Jonsen, “Medical Futility”; Robert D. Truog, A S. Brett, and Joel Frader, “The Problem with Futility,” NEJM 326 (1992): 1560‐64
    • (1988) JAMA , vol.260 , pp. 2094-2095
    • Youngner1
  • 8
    • 84985239896 scopus 로고
    • “The Linares Affair,”
    • Rudy Linares used a gun, not to coerce physicians to continue treating, but to cease life‐support for his permanently unconscious young son. See
    • (1989) Law, Medicine & Health Care , vol.17 , pp. 308-315
    • Lantos1    Miles2    Cassel3
  • 9
    • 84977716774 scopus 로고
    • For example, Superintendent of Belchertown v. Saikewicz, Mass., 370 N.E. 2d 417. See also Brophy v. New England Sinai Hosp., Inc., 497 N.E. 2d 626 (Mass. 1986); Matter of Farrell, 529 A.2d 404 (N.J. 1987); Gray by Gray v. Romeo, 697 F. Supp. 580 (D.R.I. 1988).
    • (1976)
  • 10
    • 84977718846 scopus 로고
    • In re Estate of Longeway, 549 N.E.2d 292 (Ill.), at 299. See also Brophy v. New England Sinai Hosp., Inc., 497 N.E. 2d 626 (Mass. 1986), at 639.
    • (1989)
  • 11
    • 84977707029 scopus 로고
    • Matter of Farrell, 529 A.2d 404 (N.J.), at 412.
    • (1987)
  • 12
    • 84977702370 scopus 로고
    • In a few cases, courts have actually compelled institutions—and thereby their staffs—to act contrary to their avowed moral precepts. In some instances the court found that the institution did not announce its policy to the patient at the time of admission, while others ruled that institutions' policies are subordinate to patients' rights in these cases. See Gray by Gray v. Romeo, 697 F. Supp. 580 (D.R.I.); Matter of Jobes, 529 A2d 434 (N.J. 1987); Elbaum by Elbaum v. Grace Plaza of Great Neck, 544 N.Y.S. 2d 840 A.D. 2 Dept. 1989; In re Requena, 517 A.2d 886 (N.J. Super. Ch. 1986).
    • (1988)
  • 15
    • 0027296648 scopus 로고
    • “Beyond Autonomy—Physicians' Refusal to Use Life‐Prolonging Extracorporeal Membrane Oxygenation,”
    • F. H. Marsh and A Staver, “Physician Authority for Unilateral DNR Orders,” Journal of Law and Medicine 12 (1991): 115‐65
    • (1993) NEJM , vol.329 , pp. 354-357
    • Paris1
  • 17
    • 84977722424 scopus 로고
    • Payton v. Weaver, 182 Cal. Rptr. 225 (Cal. App. 1 Dist.), at 229.
    • (1982)
  • 18
    • 84977718931 scopus 로고
    • In ruling that a PVS patient was entitled to refuse artificial nutrition and hydration and to remain at the hospital despite its pro‐life moral policy, the Requena court conceded that staff would be required to act contrary to their own values. Unfortunately, the court wrote off this intrusion on their integrity as mere emotional stress, and consoled itself by noting that “they are well and whole people. They have full and vibrant lives ahead of them.” In re Requena, 517 A.2d 886 (N.J. Super. Ch.), at 893. Whether or not the court is right in its emotional and its policy analyses, it was arguably wrong in reducing moral values and personal integrity to such side issues.
    • (1986)
  • 19
    • 0025777648 scopus 로고
    • “Guidelines for the Appropriate Use of Do‐Not‐Resuscitate Orders,”
    • Several organizations have offered guidelines. See, ; American Thoracic Society, “Withholding and Withdrawing Life‐Sustaining Therapy,” Annals of Internal Medicine 115 (1991): 478‐85; Michael Rie, “The Limits of a Wish,” Hastings Center Report 21, no. 4 (1991): 24–27
    • (1991) JAMA , vol.265 , pp. 1868-1871
  • 20
    • 0024558218 scopus 로고
    • “Fiscal Scarcity and the Inevitability of Bedside Budget Balancing,”
    • “Cost Containment: Challenging Fidelity and Justice,” Hastings Center Report 18 (1988): 20–25
    • (1989) Archives of Internal Medicine , vol.149 , pp. 1012-1015
    • Morreim1
  • 21
    • 0022628753 scopus 로고
    • “Intensive Care Units, Scarce Resources, and Conflicting Principles of Justice,”
    • (1986) JAMA , vol.255 , pp. 1159-1164
    • Engelhardt1    Rie2
  • 22
    • 0026861283 scopus 로고
    • “Triage in the ICU,”
    • see also M. D. Swenson, “Scarcity in the Intensive Care Unit: Principles of Justice for Rationing ICU Beds,” American Journal of Medicine 92 (1992): 551‐55; Robert M. Veatch and C. M. Spicer, “Medically Futile Care: The Role of the Physician in Setting Limits,” American Journal of Law & Medicine 18 (1992): 15–36
    • (1992) Hastings Center Report , vol.22 , Issue.2 , pp. 13-17
    • Truog1
  • 23
    • 84977724915 scopus 로고
    • “Triage in the ICU”; W. A Knaus, D. P. Wagner, and J. Lynn, “Short‐Term Mortality Predictions for Critically Ill Hospitalized Adults: Science and Ethics,”
    • (1991) Science , vol.254 , pp. 389-394
    • Truog1
  • 24
    • 84977706237 scopus 로고    scopus 로고
    • “Informed Demand,” p.
    • Miles1
  • 28
    • 84977738317 scopus 로고    scopus 로고
    • “The Significance of a Wish,” p.
    • Ackerman1
  • 29
    • 0026769394 scopus 로고
    • “The American Health Care System: Private Insurance,”
    • at 1719
    • (1992) NEJM , vol.326 , pp. 1715-1720
    • Iglehart1
  • 31
    • 0005173648 scopus 로고
    • “Practice Guidelines for Medical Care: The Policy Rationale,”
    • P. E. Kalb, “Controlling Health Care Costs by Controlling Technology: A Private Contractual Approach,” Yale Law Journal 99 (1990): 1109‐26; Mark A. Hall and Gerard F. Anderson, “Health Insurers' Assessment of Medical Necessity,” University of Pennsylvania Law Review 140 (1992): 1637–1712. On one view, subscribers to a particular plan should be empowered collectively to set default rules for support of patients in profoundly diminished life. See Linda L. Emanuel and Ezekiel J. Emanuel, “Decisions at the End of Life: Guided by Communities of Patients,” Hastings Center Report 23, no. 5 (1993): 6–14
    • (1990) St. Louis University Law Journal , vol.34 , pp. 777-819
    • Havighurst1

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