In what may prove to be the most controversial medicolegal decision of the year, the Massachusetts Supreme Judicial Court has ruled that, in certain cases, courts are the proper forum in which life-sustaining medical decisions should be made. The controversy goes deep. It involves questions of who should make life-prolonging decisions, in what forum, and on what criteria. Until the last few years, these questions arose almost exclusively in the context of Jehovah's Witnesses cases — cases in which life-saving blood transfusions were being refused for religious reasons. But with society's increasing consciousness about the way people die in hospitals, medical decisions are increasingly coming under public scrutiny.

Death, of course, is a natural process and a uniquely personal experience. If pressed to categorize it, most would probably term the major controversies surrounding it ethical, rather than medical or legal. Nevertheless, there is a trend to ask the courts whether or not life-sustaining treatment should or should not be withheld from patients who are unable to make this decision themselves.