Americans United for Life published “Studies in Law and Medicine” in the 1970s and 1980s, spotlighting issues pertaining to the human right to life across the bioethics spectrum. As Americans United for Life celebrates our 50th anniversary, we are making these issues available for the first time since their print publication.
The Legal Aspects of Withdrawing Nourishment by Dennis J. Horan, J.D. and Edward R. Grant, J.D.
The development of medical jurisprudence on the withdrawal of life-sustaining medical treatment entered a new phase with the divergent opinions rendered by appellate courts in California and New Jersey respectively in People v. Barber and Matter of Conroy. These opinions have both responded to, and spurred increased interest in, the debate over whether nourishment by nasogastric tube, intravenous tube, or other “mechanical” measures can ever be withdrawn from a patient. Such decisions are fraught with ethical and legal controversy: while some argue that there is logically no difference between withdrawing nourishment and withdrawing treatments such as respirators hemodialysis, there is clearly resistance among physicians, ethicists, and legal authorities to considering nourishment on a par with other life-support systems. However, the basic fact that withdrawal of nourishment introduces a new cause of death—dehydration and starvation—that may not be related to the underlying disease, constitutes adequate empirical grounds for demanding a more cautious legal approach, if not a different rule of law, for cases involving withdrawal of nourishment.
It is to be hoped that the Conroy opinion of the New Jersey appellate panel will have a far greater impact on the developing law in this area. The court displayed a noteworthy sensitivity to the two-fold rights of incompetent patients—the right to be treated, and the right to not be over treated—as well as to the ethical debate surrounding nourishment of seriously-ill patients. By reaffirming that the withdrawal of life-support measures from the terminally-ill and permanently comatose does not justify euthanasia of these, or other classes of patients, the court took a consensus on treatment issues that has developed since the promulgation of Quinlan. Most importantly, Conroy ensured that the constitutional right to privacy that lies at the heart of Quinlan will not be allowed to open the door for the legalization of euthanasia. Such vigilance is essential if a medical ethics that preserves the rights of individual patients is to be enshrined in our jurisprudence.