Abstract
In this issue ofThe Journal, Sprung1finds American medicine further along the road to euthanasia than is commonly thought. His argument can be summarized as follows: With the development of the technology of life support during the past 30 years, severely ill persons have survived in coma, in the chronic vegetative state, or in other states of great impairment. These persons formerly would have died relatively promptly after the insult that precipitated their condition. Now they are shielded from cardiopulmonary collapse and by the modern forms of life support, which extend from complex volume ventilators to simple methods of feeding by gastrostomy tube. To cope with the problems presented by this population, our society has revised the definition of death (as in the Harvard report of 1968)2and relaxed the standards for maintenance of life (as in theQuinlancase of 1976).3Who may be
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