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HEALTH ETHICS TODAY
Volume 11, Number 1, February 2000
Editor's
Forum
Al-Noor Nathoo
Executive Director and Southern Alberta Coordinator
Provincial Health Ethics Network, Alberta
Recently, the case of Andrew & Helene Sawatzky, in which a Winnipeg
woman initiated court proceedings to have a 'Do Not Resuscitate' order
removed from her husband's medical chart, brought to the public eye
a long-standing controversy regarding value differences between health
care recipients and providers. Stemming from the theme of the 1999
Annual Conference of the Provincial Health Ethics Network (PHEN), this
issue of Health Ethics Today explores various forms that such disagreements
often take. These include the enduring controversy surrounding so-called
'non-beneficial' or 'futile' treatments, conflicting opinion regarding
the best of various alternative courses of therapy, and questions of
best interest or substituted judgment when care recipients are incapable
of making or expressing informed judgments.
While relatively few, if any, topics in bioethics lend themselves
to being resolved with relative ease, the questions addressed in this
issue have proven to been particularly problematic and vexing. They
involve issues of resource allocation, respect for culture, limits
of patient autonomy, the dangers of conflating medical determinations
and value judgments, and the difficulty involved in achieving an appropriate
balance between individual preference and social good. In addition
to thought-provoking summary pieces by conference speakers Alister
Browne and Ted Keyserlingk, the popular case study format is used by
Stan Whitsett and Kathy Oberle to engage similar issues, with added
twists of disagreements between health care providers and even (!)
between ethics committees. Chip Doig and Randall Sargent round out
the issue with thorough reviews - one from an acute care and the latter
from a long-term care provider perspective - on the recent publication
of American Bioethicist Susan Rubin's When Doctors Say No: The Battleground
of Medical Futility.
As always, we welcome reader's comments and reactions to the thoughts
expressed in these pages, as part of our continued efforts to turn
'mono-' into 'dia-' logue.
Contents
Health Ethics Today Credits
Editorial Committee:
Vangie Bergum, Al-Noor
Nathoo, Eileen Crookes, Bashir Jiwani, Laura
Shanner, Paul Byrne, Glenn Griener
Health Ethics Today is produced by the John Dossetor Health Ethics
Centre, University of Alberta and the Provincial Health Ethics Network.
The opinions expressed in this newsletter are those of the authors
only and not necessarily those of the John Dossetor Health Ethics Centre
or the Provincial Health Ethics Network.
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