Price D M, Armstrong P W
Law Med Health Care. 1989 Fall;17(3):255-63. doi: 10.1111/j.1748-720x.1989.tb01103.x.
A state government official in New Jersey has written to administrators of the state's nursing homes outlining what he understands to be certain implications of the Conroy, Peter and Farrell decisions of the New Jersey Supreme Court. These include mandatory reporting to and investigation by his office of virtually all cases of contemplated withholding or withdrawal of life-sustaining treatment, even decisions not to hospitalize or dialyze. This directive has aroused health professionals and advocates for patient privacy. The resulting urgent effort to fashion an acceptable alternative to decisional review by government agents is reminiscent of the process which was sparked by the federal government's promulgation of the "Baby Doe regulations" some years ago. Now, as then, a consensus is being fashioned by a wide spectrum of participants. The likely candidate for an alternative to "Granny Doe squads" is, once again, some form or forms of the institutional ethics committee. Any acceptable proposals will have to satisfy the requirement of public confidence in the face of a perception that elderly nursing home patients are particularly vulnerable to "abuse." They should, in the view of these participants in the debate, also acknowledge relevant differences among nursing homes and enhance, rather than discourage, the exercise of responsibility by nursing home leaders and staff members.
新泽西州的一位政府官员致信该州疗养院的管理人员，概述了他所理解的新泽西州最高法院对康罗伊、彼得和法雷尔案判决的某些影响。这些影响包括，几乎所有考虑停止或撤销维持生命治疗的案例，甚至包括不进行住院治疗或透析的决定，都必须向他的办公室报告并接受调查。这一指令引起了医疗专业人员以及患者隐私倡导者的关注。由此引发的紧急行动，即努力制定一种可接受的替代方案，以取代政府机构进行的决策审查，这让人想起几年前联邦政府颁布《“婴儿多伊”规定》后引发的类似过程。现在，就像当时一样，广泛的参与者正在形成一种共识。替代“老奶奶多伊小组”的可能候选方案再次是某种形式或多种形式的机构伦理委员会。面对这样一种观念，即养老院的老年患者特别容易受到“虐待”，任何可接受的提议都必须满足公众信任的要求。在这些参与辩论的人看来，这些提议还应该承认不同疗养院之间的相关差异，并鼓励而不是阻碍养老院领导和工作人员履行职责。
