Trying Not to Talk Forever: A Tool for Change

George Annas’ review’ finds most of what is in the Hastings Center’s Guidelines on the Termination of Life-Sustaining Treatment und the Cure of the Dying “solid” but concludes that it is not at all clear how to prompt a physician to plan with her patient for terminal care if she is one of those physicians who tends to avoid the topic.

Abstract

George Annas’ review finds most of what is in the Hastings Center’s Guidelines on the Termination of Life-Sustaining Treatment and the Care of the Dying “solid.” He takes no issue with the major substantive points. The fundamental premise of the book—that patients’ interests must be protected and their decision-making authority defended—is a view Professor Annas has long championed as well. Despite this basic agreement, Annas’ criticisms would be significant ones if the Guidelines were what he presents them to be. But they clearly are not. As the Guidelines themselves state: These are ethics guidelines; they are not legal guidelines. They are an attempt to offer practical and reasonably concise suggestions for how to make decisions; they are no substitute for the literature on the pros and cons of different approaches to the termination of treatment. They are meant to provoke a necessary process of debate within a health care institution; they are not the final moral truth.