The ethics committee met and discussed the case with the surgeon. Just prior to this, the bioethics committee at a nearby medical center received a referral for a similar case. That committee had already undertaken a thorough review of the literature and the legal proceedings involved in the Seattle Ashley case. The medical center committee agreed to share their findings and deliberations with the children’s hospital committee and sent two representatives (both attorneys) to present their information. In addition, members of the children’s hospital committee had a conference call with the pediatric endocrinologist who had been involved with the case at the medical center.

More than ever, the way we live our lives has become subject to our own decisionmaking. Our whole way of living, in particular what we do to our body, has become the expression of personal lifestyle choices. Because we can make changes to our body according to our own individual preferences, every aspect of our life begins to be seen as the result of individual and voluntary decisions. The comparison with advertising is pertinent here: we should no longer accept the way we are but can choose from a variety of options. Go to any supermarket and look around: innumerable products are promoted because of their healthy ingredients, whether to lower our cholesterol or heighten our natural resistance. And, of course, we buy what is on offer.

Approximately one in three American adults has executed a living will or healthcare declaration stating personal preferences regarding medical treatment in the event that he or she becomes terminally ill and unable to communicate. This figure stands in striking contrast to the 90% of Americans who, when asked, express specific wishes regarding their choice of care under such circumstances. Congress attempted to increase the number of Americans with advance directives when it passed the Patient Self Determination Act in 1990, billed at the time as the “Miranda Warning” of medicine, which requires hospitals and nursing homes receiving federal funds both to inform patients of their right to refuse life-sustaining care and to record all written directive in patients’ charts.

Most reasonable people acknowledge that Karl Helge Hampus Hellekant has committed a grave moral offense: the 33-year-old Swede, also known as Karl Svensson, was convicted of killing trade unionist Björn Söderberg in 1999 at the behest of the Swedish neo-Nazi movement. What is not so clear is whether Hellekant, who is currently free on parole, should be permitted to become a physician. The former extremist was admitted to the medical school at Stockholm’s Karolinska Institute in 2007, but later expelled—following considerable public debate—after school officials discovered that he was temporarily unable to verify his academic records. Sweden’s most prestigious medical school, Uppsala, subsequently confirmed these records and matricatulated him in 2008.

This section is meant to be a mutual effort. If you find an article you think should be abstracted in this section, do not be bashful—submit it for consideration to feature editors Kenneth V. Iserson and Barry Morenz at [email protected].

In 1985, after a long university career teaching philosophy and humanities, in which my only serious worries over the years were centered on such things as getting promoted, course preparations, and faculty affairs, I found myself confronted, as a medical ethics committee member, with a life and death issue. It concerned the care of an infant suffering from posthemorrhagic hydrocephalus, for which there appeared to be no permanently effective treatment. The parents refused to consider the discontinuing of aggressive care even though this prolonged the suffering of their child. This standoff continued for 5 months, until the parents decided that it was God’s wish that aggressive treatment cease.

This section is meant to be a mutual effort. If you find an article you think should be abstracted in this section, do not be bashful—submit it for consideration to feature editors Kenneth V. Iserson and Barry Morenz at [email protected].