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April 22/29, 1998

Deciding Life and Death in the Courtroom: Debate and Clarification—Reply

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;279(16):1259-1261. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-16-jac80007

In Reply.—What is the ethically appropriate role for the patient, physician, or the judiciary in end-of-life decisions? There is no correct answer, but Dr Farrell inappropriately elevates the physician's role and undervalues the patient's role. The physician certainly has a duty to treat patients beneficently. If paternalism means that a physician should provide the patient with honest advice about treatment and care to promote health, well-being, and comfort, then I favor paternalism. If paternalism means substituting the physician's view for that of the patient, it fails to respect the patient as a person who is capable of rational thought and decision making.