All treatments, even those labeled as supportive, have burdens as well as benefits. Patients and their surrogates have the right to finally decide whether the offered treatment's cost-benefit calculation is acceptable.

In mid-1996, the United States Supreme Court agreed to hear arguments and rule on two lower court cases that would, if upheld, legalize physician-assisted suicide in twelve states, including California. At about the same time, at a national meeting dealing with this controversial topic, several participants from the San Francisco Bay Area got together to ask, Based on the old principle of the suggestion was made that the local ethics committee network might be interested in developing guidelines for the care (...) of patients at the end of life in the unlikely event that laws would change by Supreme Court action. Thus the coordinator of the Bay Area Network of Ethics Committees (BANEC) and several BANEC members began to discuss this question. (shrink)