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March 9, 1994

Standard of Care: The Law of American Bioethics

JAMA. 1994;271(10):795. doi:10.1001/jama.1994.03510340085047

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Until the early 1960s, the interaction of law and medicine was episodic and primarily focused on forensic pathology and criminal cases. Then, mainly in the 1970s, came the great and disturbing brouhaha of medical malpractice and the need for tort reform, which continues to this day. At about the same time there arose increasingly perplexing problems of medical ethics. The 1970s and 1980s were the setting for the complex reproductive issues of abortion, in vitro fertilization, and surrogate motherhood, as well as the frustrating and expensive series of cases involving brain death and withdrawal of ventilatory and other life-support mechanisms. Physicians were (and are) often puzzled, since there seem to be no straightforward answers to these problems, and frustrated because hospital "ethics committees" often generate more talk than action and lawyers and judges get involved without providing much in the way of sensible solutions.

George Annas works at the Boston

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