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March 27, 1991

Medical Law, Medical Ethics-Reply

Author Affiliations

American Medical Association Chicago, Ill

American Medical Association Chicago, Ill

JAMA. 1991;265(12):1527. doi:10.1001/jama.1991.03460120041024

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In Reply. —  There was no intent to suggest that ethical behavior is defined by the law or that ethical behavior should be defined by the law. I, too, believe that it is important to distinguish between law and ethics. The point of my statement is that decisions about life-sustaining treatment are primarily medical and ethical decisions rather than legal decisions. Indeed, if physicians and family members act in accordance with medical and ethical principles on withdrawal of treatment, they generally can be confident that they are also acting in accordance with the law. However, there may be states, like Missouri, where the judiciary or the legislature has imposed a legal standard that is more stringent than would be required by either medicine or ethics. For those states, I would urge that the law be changed to coincide with medical and ethical principles, but I am not prepared to advise