Abstract

Spielman’s taxonomy of collective decision making about medical futility is timely and insightful. Her conclusion, that laws are the best reflection we have of collective values, may be accurate. However, a closer look at the six alternatives for collective decisions is necessary before we rely too heavily on the legislature.The first two alternatives, decisions by professional organizations and by health care facilities, smack of paternalism. Spielman suggests that statements from professional organizations or health care facilities express professional values and lack adequate input from the public. Could it be that some of these statements in fact may be the best reflections of public attitudes?