Ethics Committees and Decisions to Limit Care

Comment These two papers published in back-to-back sequence in a recent issue of The Journal of the American Medical Association emphasize the increasingly close scrutiny being given to ethical issues involved in provision and withdrawal of life-sustaining (as opposed to life-saving) therapeutic interventions. Is the establishment of an Ethics Consultation Service an advance in the medical care of critically ill patients? Or is it, as one cynical colleague expressed, an outgrowth of the difficult mediolegal climate prevailing today. By calling a consultant in this area, is one more concerned over the patient or is one simply taking a “diffusion of culpability” approach in the event of a legal altercation. Certainly one would hope for the former, but one wonders. Richard F. Davis, M.D.