Abstract
The scalpel is a two-edged sword. Surgeons frequently wield it to vanquish death and to restore patients with malignant tumors, severe disabilities or maimed bodies to healthy active lives. On other occasions, all that modern surgery can achieve is to prolong the process of dying or to patch up a mangled body only enough to enable the patient to suffer through an extended period of hopeless disability during which no normal human activities are possible. More generally, modern medical technologies are increasingly used to sustain the basic biological processes in a patient long after the patient has become unable to live anything remotely like a genuinely human life or even to decide for himself whether to consent to or refuse medical treatment. Although some physicians and their patients accept a moral imperative to prolong merely biological life as long as possible and at any cost, increasingly this has come to be recognized as excessively costly to society, cruel to the family, of no value to the patient and even inconsistent with a respect for human dignity. But how could anyone else possess the authority to decide when an incompetent patient shall die?
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