Legislating Medical Ethics: A Study of the New York State Do-Not-Resuscitate Law (Philosophy and Medicine, 48)

Can medical ethics be legislated? Can a complex bioethical question be definitively answered through legislation? In July 1987 the New York State legislature experimented with legislating medical ethics by amending the state's public health law to regulate `Do Not Resuscitate' orders. The consequent law was complex and remains controversial. This volume reviews both the background bioethical debates and the elements of the public policy making process that are essential to understanding New York's experience with the DNR law. It features debates between leading exponents and critics of the law; case studies that examine the impact of New York's DNR law on clinicians, hospitals and patients; and a review of all empirical studies of the law by their lead authors. Appended to the volume is the New York State DNR law and a comprehensive set of background documents. The co-editors, __Robert Baker__ and __Martin A. Strosberg__, are both professors at Union College, Schenectady, New York. They have collaborated on many projects including, __Rationing America's Medical____Care: The Oregon Plan and Beyond__ (Brookings, 1992). Front Matter....Pages i-xviii Front Matter....Pages 1-1 Do not Resuscitate Orders: The Proposed Legislation and Report of the New York State Task Force on Life and the Law....Pages 3-7 The New York State Do-Not-Resuscitate Law: A Study of Public Policy-Making....Pages 9-31 The Legitimation and Regulation of DNR Orders....Pages 33-101 Front Matter....Pages 103-103 Taking Stock of Policies for Do-Not-Resuscitate Orders: Perception and Practice....Pages 105-132 Where are We Going with Do-Not-Resuscitate Policies?....Pages 133-136 New York State’s Do-Not-Resuscitate Law....Pages 137-140 New York’s Do-Not-Resuscitate Law: Bad Law, Bad Medicine, and Bad Ethics....Pages 141-155 Edited Transcript of Question & Answer Sessions at Union College Conference....Pages 157-159 Front Matter....Pages 161-161 Implementation of the New York Do-Not-Resuscitate Law at a Teaching Hospital....Pages 163-168 One Family’s Experience with the New York DNR Law....Pages 169-171 When the Ambulance Goes Home: A Tragic Flaw in the New York State Do-Not-Resuscitate Law....Pages 173-179 Implementation of the New York State DNR Law at a Community Hospital....Pages 181-186 The New York DNR Law and the Disabled: The Experience of the New York State Office of Mental Retardation and Developmental Disabilities....Pages 187-203 Striking a Balance....Pages 205-212 Front Matter....Pages 213-213 The Do-Not-Resuscitate Order as Ritual....Pages 215-225 New York’s Do-Not-Resuscitate Law: Burden or Benefit?....Pages 227-234 Does the New York State DNR Law Prevent Medically Inappropriate DNR?....Pages 235-240 The Effects of a Hospital Policy and State Legislation on Resuscitation Orders for Geriatric Patients....Pages 241-250 The New York State DNR Law: Views of the Members of the New York Chapter of the American College of Physicians....Pages 251-261 The 1988 DNR Reforms: A Comparative Study of the Impact of the New York DNR Law and the Jcaho Accreditation Requirements....Pages 263-301 Front Matter....Pages 213-213 Differences in Clinicians’ Reactions to the New York State DNR Law....Pages 303-321 Front Matter....Pages 323-323 An Assessment of the Union College Study and a Response to Robert Baker’s Analysis of the DNR Law....Pages 325-332 A Review of the Empirical Studies of the DNR Law and a Rejoinder to Tracy Miller....Pages 333-346 Front Matter....Pages 347-347 Article 29-BL. 1987, CH. 818. Effective April 1, 1988....Pages 349-367 Guidelines for Hospitals and Physicians on “Do-Not-Resuscitate” — 20 September 1982....Pages 369-370 Deciding to Forego Life-Sustaining Treatment (1983) Excerpted....Pages 371-379 Do not Resuscitate Orders — The Proposed Legislation and Report of the New York State Task Force on Life and the Law — 2nd Edition,Condensed....Pages 381-413 Do-Not-Resuscitate Orders: Questions and Answers for Health Care Professionals....Pages 415-438 Letter to New York State Assembly Minority Counsel Larry Digiulio....Pages 439-444 Amendments to the New York Public Health Law 29-B (1991)....Pages 445-454 Back Matter....Pages 455-471

Can medical ethics be legislated? Can a complex bioethical question be definitively answered through legislation? In July 1987 the New York State legislature experimented with legislating medical ethics by amending the state's public health law to regulate 'Do Not Resuscitate' orders. The consequent law was complex and remains controversial. This volume reviews both the background bioethical debates and the elements of the public policy making process that are essential to understanding New York's experience with the DNR law. It features debates between leading exponents and critics of the law; case studies that examine the impact of New York's DNR law on clinicians, hospitals and patients; and a review of all empirical studies of the law by their lead authors. Appended to the volume is the New York State DNR law and a comprehensive set of background documents.
The co-editors, Robert Baker and Martin A. Strosberg, are both professors at Union College, Schenectady, New York. They have collaborated on many projects including, Rationing America's Medical Care: The Oregon Plan and Beyond (Brookings, 1992).