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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).
List of contents
I / The Task Force and the Law.- Executive Summary.- The New York State Do-Not-Resuscitate Law: A Study of Public Policy-Making.- The Legitimation and Regulation of DNR Orders.- II / The DNR Controversy in New York State.- Taking Stock of Policies for Do-Not-Resuscitate Orders: Perception and Practice.- Where Are We Going with Do-Not-Resuscitate Policies?.- New York State's Do-Not-Resuscitate Law.- New York's Do-Not-Resuscitate Law: Bad Law, Bad Medicine, and Bad Ethics.- Edited Transcript of Question & Answer Sessions at Union College Conference.- III / Case Studies.- Implementation of the New York Do-Not-Resuscitate Law at a Teaching Hospital.- One Family's Experience with the New York DNR Law.- When the Ambulance Goes Home: A Tragic Flaw in the New York State Do-Not-Resuscitate Law.- Implementation of the New York State DNR Law at a Community Hospital.- The New York DNR Law and the Disabled: The Experience of the New York State Office of Mental Retardation and Developmental Disabilities.- Striking a Balance.- IV / Research.- The Do-Not-Resuscitate Order as Ritual.- New York's Do-Not-Resuscitate Law: Burden or Benefit?.- Does the New York State DNR Law Prevent Medically Inappropriate DNR?.- The Effects of a Hospital Policy and State Legislation on Resuscitation Orders for Geriatric Patients.- The New York State DNR Law: Views of the Members of the New York Chapter of the American College of Physicians.- The 1988 DNR Reforms: A Comparative Study of the Impact of the New York DNR Law and the Jcaho Accreditation Requirements.- Differences in Clinicians' Reactions to the New York State DNR Law.- V / Retrospection and Reflection.- An Assessment of the Union College Study and a Response to Robert Baker's Analysis of the DNR Law.- A Review of the EmpiricalStudies of the DNR Law and a Rejoinder to Tracy E. Miller.- Appendices The Genealogy of New York State's Do-Not-Resuscitate Law.- Article 29 (1987) - New York State Legislature.- Guidelines for Hospitals and Physicians on "Do-Not-Resuscitate" (1982).- Deciding to Forego Life-Sustaining Treatment (1983, Excerpted).- Do-Not-Resuscitate Orders: The Proposed Legislation and Report of the New York State Task Force on Life and the Law (1986, 1988, 2nd Edition Condensed).- Do-Not-Resuscitate Orders: Questions and Answers for Health Care Professionals (1988).- Letter to New York State Assembly Minority Counsel Larry Digiulio (1991).- Amendments to the New York Public Health Law 29-B (1991).- Notes on Editors and Contributors.
