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PubMed1989

Donum Vitae: civil law and moral values.

The Instruction reminds us that reproductive medicine has become part of our social reality and as such justifies the intervention of public authorities. The Instruction suggests relevant principles which should guide appropriate legislation. This essay analyzes how far the French government has taken these fundamental principles into account.

Advisory Committees↗
PubMed1994

Intolerant tolerance.

The Hyde Amendment and Roman Catholic attempts to put restrictions on Title X funding have been criticized for being intolerant. However, such criticism fails to appreciate that there are two competing notions of tolerance, one focusing on the limits of state force and accepting pluralism as unavoidable, and the other focusing on the limits of knowledge and advancing pluralism as a good. These two types of tolerance, illustrated in the writings of John Locke and J.S. Mill, each involve an intolerance. In a pluralistic context where the free exercise of religion is respected, John Locke's account of tolerance is preferable. However, it (in a reconstructed form) leads to a minimal state. Positive entitlements to benefits like artificial contraception or nontherapeutic abortions can legitimately be resisted, because an intolerance has already been shown with respect to those that consider the benefit immoral, since their resources have been coopted by taxation to advance an end that is contrary to their own. There is a sliding scale from tolerance (viewed as forbearance) to the affirmation of communal integrity, and this scale maps on to the continuum from negative to positive rights.

Attitude↗
PubMedDate not supplied

CHA amicus curiae brief on physician-assisted suicide. Catholic Health Association.

The Catholic Health Association of the United States submitted an amicus curiae brief to the U.S. Supreme Court last October in support of petitioners Dennis C. Vacco, attorney general of the state of New York (in the case Vacco v. Timothy E. Quill, MD, et at.), and the state of Washington (in State of Washington, et al. v. Harold Glucksberg, MD, et al.). The brief was filed as the Court agreed to hear arguments on the issue of whether terminally ill people have a constitutionally protected right to physician-assisted suicide. In January 1997 the petitioners went before the Court to argue appeals to federal appellate rulings that struck down New York and Washington laws making physician-assisted suicide a crime. The Court is expected to rule in late June.

Catholicism↗
PubMedDate not supplied

Bishops' response to Act on Rights of Terminally Ill.

In August 1985 the National Conference of Commissioners on Uniform State Laws drafted a document entitled The Uniform Rights of the Terminally Ill Act, which it recommended for enactment by all U.S. states. The act attempts to set uniform, clear guidelines for advance directives, or living wills--written declarations made by a patient that are used to guide treatment decisions should the patient become incompetent and terminally ill. The act limits the scope of an advance directive to the withdrawal or withholding of "life-sustaining treatment," which is "any medical procedure or intervention that when administered to a qualified patient will serve only to prolong the process of dying." Qualified patients are those with a terminal condition, which is "an incurable or irreversible condition that without the administration of life-sustaining treatment will, in the opinion of the attending physician, result in death within a relatively short time." The National Conference of Catholic Bishops (NCCB) Committee for Pro-Life Activities responded to the act in July 1986. The NCCB wishes to narrow the act's scope to apply only to patients in the "final stage of a terminal condition." Other specific concerns are the withdrawal of artificial nutrition and hydration, the need for communication with the family in making decisions, and the protection of an unborn child's life when the mother fulfills the conditions of the act and her living will stipulates a desire for withdrawal of life-sustaining treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Catholicism↗
PubMed1985

Florida law creates artificial sustenance dilemma.

Although a model statute for its inclusiveness, Florida's 1984 Life-Prolonging Procedure Act excludes "sustenance" from its definition of life-prolonging procedures that may be forgone. The majority legal opinion has held that the law prohibits withdrawing or withholding nutrition and hydration by whatever means they must be provided. Also, a Florida circuit court decision has disavowed the applicability of the argument that extraordinary life-prolonging procedures violate a patient's constitutional rights. An amendment to repeal the sustenance clause failed, making the question of whether to withdraw--or even initiate--artificial feeding an entirely legal decision, rather than a clinical and bioethical one. The act will have enormous effects at long-term care facilities, where elderly and debilitated patients, as well as the terminally ill and comatose patients the statute addresses, may be force-fed against their wishes. Society must decide whether providing nutrition and hydration is "medical treatment" or whether, because it is basic to human life, it cannot be considered as such. To make such a determination, one must understand that feeding technology includes invasive procedures which might be considered extraordinary. The Florida law, however, does not distinguish between degrees of invasiveness. The law demonstrates that resolving clinical and ethical dilemmas through legislation may result in society surrendering the freedom and responsibility that are essential to ethical decision making.

Catholicism↗
PubMed1995

Revisiting New York State's proposed surrogate decision-making legislation.

More than 2 years have passed since legislation was first proposed in New York to remedy the absence of legal authority for family members who must make important health care decisions for incapacitated loved ones who have left no advance directives. This legislation, the "Family Health Care Decisions Act," included standards for surrogate decision-making and safeguards for surrogate decisions about the use of life-sustaining treatments. This article argues in favor of the legislation and discusses the concerns presented in opposition.

Advance Directives↗
PubMed1987

Feeding of severely demented patients in institutions: interviews with caregivers in Israel.

In an exploratory, open-ended, and non-random study, 60 health care workers in nine long-term care institutions in Israel were questioned regarding their experiences, thoughts and feelings related to force feeding senile demented patients. The main findings were analysed according to an ethical decision-making model. Israeli care workers tended to ground their explanations in traditional Jewish sanctity of life ethics. Their actions as well as their emotional reactions seemed the logical outcome of this world view: patients were force fed and caregivers did not feel guilt for using force or accepting suffering, since they felt obliged to preserve life and thus their actions were right. They did feel ugly and upset about the situation. While most caregivers felt that force feeding was the only acceptable route in an institution, some suggested family home care where discretionary case by case ethics was seen as a viable alternative. This paper compares the Israeli interview results with those of the Swedish studies.

Attitude of Health Personnel↗
PubMed1993

Involvement of rabbis in counseling and referral for genetic conditions: results of a survey.

Members of the New York Board of Rabbis were surveyed in the summer of 1991 to assess their activity in counseling congregants on issues related to genetics. Of a sample of 257 members, 181 (70.4%) responded to the questionnaire, and 175 of the responses were analyzed. More than half (56.0%) of the rabbis discussed health issues as a routine part of premarital counseling, and 22.3% had counseled a couple after prenatal diagnosis of an abnormal fetus. Orthodox rabbis were more likely than rabbis from other branches of Judaism to have contacted medical personnel in these cases, and they reported more involvement in helping families after the birth of a child with a hereditary condition or birth defect. However, a majority (90.9%) of rabbis from all branches would refer such a family for genetic counseling. Ninety-four rabbis (53.7%) discussed Tay-Sachs carrier testing with congregants. These rabbis tended to be Reform, to be younger, and to have fewer years in the rabbinate. Reform rabbis also scored significantly higher than did Orthodox or Conservative rabbis on knowledge questions about Jewish genetic diseases and were more active in distributing pertinent literature to congregants. Even though nearly 90% of the sample viewed counseling on genetic issues as part of their rabbinical role, most rabbis, even those who actually counseled on these issues, felt poorly prepared to do so. Recommendations are made for increased programming in rabbinical schools and for outreach from the genetics community.

Adult↗