NEJM Article About Medical Futility Laws

The New England Journal of Medicine has an article by Robert D. Truog, M.D., a professor of medical ethics and pediatrics, that comments on the Emilio Gonzales case in Austin, Texas. The article gives a good overview of the provisions of the Texas Advance Directives Act, which Emilio's doctors invoked to authorize the removal of his life support, and it presents a variety of reasons that doctors give to justify their refusal to continue treatment. It also discusses hospital ethics committees, which are authorized to decide whether or not it is ethically appropriate to trump the surrogate's wishes to continue treatment, and raises a number of objections to them, noting in particular their constitution, which in the case of Emilio, he argues, was hardly "a jury of peers for a low-income woman of color and her infant son." He discusses various suggestions for improving hospital ethics committees, and the pros and cons of these, including those associated with the formation of "ad hoc committees."

To listen to an interview with Dr. Truog go to: http://www/nejm.org.