In this Article, Dr. Arnold S. Relman, the Editor of The New England Journal of Medicine, takes issue with the 1977 Saikewicz decision of the Massachusetts Supreme Judicial Court, which addressed the question of whether chemotherapy should be provided to a severely retarded 67-year-old man who had developed acute leukemia. Dr. Relman interprets Saikewicz as requiring that medical treatment decisions involving the life or death of incompetent patients must receive judicial resolution instead of resolution by the patient's family and physicians. This rule, he asserts, violates medical tradition, and its application will result in serious problems, such as the unnecessary prolongation of the suffering of many seriously ill persons. Dr. Relman proposes, as an alternative to the Saikewicz approach, that in such cases judicial resolution should occur only when there is disagreement, concerning treatment, among next of kin, or between next of kin and attending physicians, or when there is a complaint of injury or of wrongdoing. In all other situations, resolution solely by next of kin and attending physicians should be sufficient. Adequate protection of the interests of the incompetent patient could be achieved by a requirement that the physician in charge document in the medical record that the treatment decision received the concurrence of the family and advance approval of a group of the physician's professional colleagues who have no vested interest in the outcome of the decision.

Founded in 1968, the American Society of Hospital Attorneys of the American Hospital Association is the country's oldest and largest association of attorneys specializing in hospital and health law. It is a measure of the rapid growth of this legal specialty that although the Society only recently held its Eleventh Annual Meeting, it has over 2100 active duespaying members on its rolls. The Board of Directors' continues to seek out as new members all attorneys who act as general or special counsel to hospitals or who have demonstrated substantial interest in the field of hospital law in some other capacity.

The birth of the world's first “test-tube baby,” a child conceived by in vitro fertilization (IVF), raises serious medical, ethical, and legal problems. This Note explores the present controversy over the use of IVF and advocates federal regulation of the technique. Furthermore, this Note argues that, in order to deter unduly hazardous use of IVF and to compensate its victims, an experimenter should be subject to civil liability for either negligent, or willful and nonconsensual, destruction of an IVF conceptus, and held strictly liable when an IVF child is born with severe defects that are attributable to the use of the technique.