November 14, 1980

The Fox Case

Author Affiliations

From the Joseph and Rose Kennedy Institute of Ethics, Georgetown University, Washington, DC.

JAMA. 1980;244(19):2165-2166. doi:10.1001/jama.1980.03310190017012

MANAGEMENT decisions in medicine, even those involving preservation of life, are profoundly personal. They are like gloves to be fit to a particular hand. For this reason, age-old wisdom has urged that decision making in health care, if it is to remain truly human and in the patient's best interest, should be controlled within the patient-family-physician relationship, always maintaining the right of appeal against potential abuses, of course.

Three rather impersonal factors (high technology, cost-containment considerations, and public entities such as the law and the courts) are becoming increasingly influential in medical treatment. Impersonal forces tend to preprogram treatment and are thus a threat to all of us. That is why I see a very ominous drift in the recent New York appellate court resolution of the Fox case.

On Oct 2, 1979, Brother Joseph Charles Fox, an 83-year-old member of the Society of Mary, suffered severe cardiorespiratory arrest during