Bioethics
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It is becoming increasingly common (at least in the United States) for doctors to appeal to futility judgments as the basis for certain types of clinical decisions, such as the decision to withhold CPR. The clinical use of futility judgments raises two basic questions regarding futility. ⋯ I argue that futility determinations need to be distinguished from two other types of value-based judgments, namely, identification of the goals of treatment and treatment decisions based on an assessment of the benefits and burdens of treatment. If this distinction is sound, it suggests a very limited role for futility determinations in clinical decision-making, a role which should serve to promote communication between doctor and patient.
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Perhaps no American state has seen more legal activity on assisting suicide than Michigan, but despite legislation, a study Commission, several legal cases and a state Supreme Court ruling, the state seems much further from a humane resolution of the question than when the activities of Dr. Jack Kevorkian began in June of 1990. This note summarizes major legal events over a twelve-month period (ending May '95), which included jury acquittal of Dr. ⋯ Kevorkian declaring assisting suicide a common law felony and ruling that in certain circumstances a person assisting suicide can be prosecuted for murder. The Commission's model decriminalization proposal and the bills subsequently introduced in the legislature (all of which to varying degrees surrounded assisting suicide with restrictions and safeguards), as well as the decision of the Supreme Court, are discussed. Certain puzzling features of the latter, especially with regard to the kind of causation that can turn helping another commit suicide into murder are noted.