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Road to Euthanasia or Right to Refuse Care?

Michael Sananman, MD
JAMA. 1990;264(14):1809. doi:10.1001/jama.1990.03450140029018.
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To the Editor.—  The informative article by Dr Sprung1 on forgoing life-sustaining treatment contains within it viable answers to his fears and those expressed in the accompanying editorial.2 It is not true that "the range of those regarded as dead" is widening each year. In fact, the strict neurological interpretation of death as whole-brain death remains as defined in the Uniform Determination of Death Act.3Dr Sprung expresses concern that judicial attitudes are becoming more permissive regarding removal of treatment. In fact, such refusal of withdrawal of therapy is only at the request of the patient or a surrogate. We must recognize the huge difference between a competent patient or his family refusing unwanted treatment and such a decision or judgment imposed on the patient by outside forces, such as physicians or administrative personnel. It is a healthy trend that the courts are moving toward allowing refusal


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