FOR THE past two decades, our society has struggled to identify the proper circumstances under which life-sustaining medical treatment should be limited. In fact, we seem to have reached a consensus on some aspects of the problem. It is generally agreed that a competent patient has the right to refuse life-sustaining treatment; when the patient is not com- petent, family members may limit treatment to serve the patient's best interests. The report by Murphy1 in this issue of THE JOURNAL examines a more controversial question that is currently at the forefront of the treatment-limitation debate\p=m-\ie,under what circumstances can life-sustaining interventions be lim- ited without the informed consent ofthe patient or family?
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