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May 1, 1991

Mercy Killing-Reply

JAMA. 1991;265(17):2189. doi:10.1001/jama.1991.03460170043016

In Reply.—  Dr Tauber extends my arguments against euthanasia of incompetent people to encompass euthanasia of competent people, and then disagrees with the result. So do I. I agree with both Drs Tauber and Kane that the appropriate use of advance directives can considerably lessen the uncertainty and guilt encountered by families facing treatment decisions for an incompetent relative. That uncertainty is poignantly illustrated in the letter from Dr Morgan. Finally, I strongly disagree with Dr Kane's assertion that all surrogate decisions are selfish. Pellegrino and Thomasma,1 among others, have argued that the concept of beneficence is a better way to view the physician-patient relationship than is the physician praternalism—patient autonomy dialectic. Clearly, most surrogate decisions are made for the patient's good.