Few healthy people welcome death, but most would welcome a quick, easy death to avoid suffering and the loss of control over their lives. We need to ask: what sort of human environment do we hope for at the end of our lives? What will the world and our own living in it look like when we know we are about to die? What kind of human relationships will sustain us through this most personal of life's experiences when we may become more dependent on others? Do we fear we will either be abandoned through lack of meaningful personal contact with significant others, or be actors in a tragi-comedy of pretense in which authentic forms of human expression are unattainable?

In a previous column I discussed the testimony of a number of nurses in the case of Ms. Sharon Siebert. That case was decided by a lower court on February 13, 1981, and this column discusses Judge Lindsay G. Arthur's opinion. Jane Hoyt, a friend, not a relative, of Ms. Siebert, brought suit to enjoin an order not to resuscitate that had been written on Ms. Siebert. The case raised a number of important issues, including whether the court would allow a suit brought by someone in Ms. Hoyt's position vis-à-vis the patient, and if it did, what legal standard the court might require in the writing of Do Not Resuscitate (DNR) orders.

What is the responsibility of a hospital to protect the general public from an employee who may cause harm? Until recently, the answer to this question was simply “none“; hospitals were not seen as having any direct responsibility for the actions of employees. But this has changed, and the current trend is to hold a hospital directly responsible for the level of care received by its patients — the hospital must provide an ongoing system to monitor performance of employees as well as staff physicians.

But what about acts of employees outside the hospital? Does a hospital have any obligation to anticipate when one of its employees poses a threat not on the job? This was the question addressed in a recent case before a California appeals court.