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A Right to Choose Death: The Judicial Trilogy of Brophy, Bouvia, and Conroy

Published online by Cambridge University Press:  28 April 2021

Extract

The law has characteristically defended life and proscribed any act to end it, for whatever reason. But sustaining life is increasingly a medical question, and decisions to end it are now cast as “treatment” decisions. Some treatment decisions that leave basic biological needs unmet are clearly intended to end a life that is “over.” The provision of food and water has a particularly intimate association with the nursing function of nurturance and care. The surgeon general, in another context, has said that nourishment in all cases is “the bottom line” and that removal of sustenance is medical neglect per se. I intend here to explore two questions: Have the courts endorsed, and should they endorse, decisions by or substitute decisions for patients who choose intentionally to end their lives in health care settings? And what rights and duties do the hospital and professional staff have to decline to withdraw artificial feeding?

Type
Case & Comment
Copyright
Copyright © American Society of Law, Medicine and Ethics 1986

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References

See generally, Lo & Dorntrand, The Guiding Hand That Feeds; Caring for the Demented Elderly, New England Journal of Medicine 311: 402 (1984); Paris & Fletcher, Infant Doe Regulations and the Absolute Requirement to Use Nourishment and Fluids for the Dying Infant, Law, Medicine & Health Care 11: 310 (1983); Steinbock, Lynn, and Callahan, Must Patients Always Be Given Food and Water?. Hastings Center Report 13: 17 (1983).Google Scholar
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In the area of withholding or withdrawing nutrition and fluids, see, e.g., Severns v. Wilmington Medical Center, 425 A.2d 156 (Del. Ch. 1980); In the Matter of Hier, 18 Mass. App. Ct. 200, 464 N.E.2d 959 (1984); Barber v. Superior Court of Los Angeles County, 147 Cal.App.3d 1006, 195 Cal. Rptr. 484 (1983); Corbett v. D'Alessandro, No. 85-1052, Fla. Ct. App. (April 18, 1986), petition for rev. den., S.Ct. Fla. July 30, 1986. See generally, Annas, Fashion and Freedom: When Artificial Feeding Should Be Withdrawn, American Journal of Public Health 75(6): 685 (1985); Gostin, A Moment in Human Development: Legal Protection, Ethical Standards and Social Policy on the Selective Non-Treatment of Handicapped Neonates, American Journal of Law & Medicine 11(1): 31 (1985); Corbett, Withholding or Withdrawing Life-Prolonging Treatment, JAMA 256 (19): 2673 (1986).Google Scholar
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Brophy at 29, quoting from Massachusetts Medical Society resolution adopted July 17, 1985.Google Scholar
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