In pursuit of my ultimate objective of being in control of my self-deliverance at the time when my physical condition no longer warrants continuance, I have joined the Hemlock Society of Los Angeles. The Society urges its members to explore with their personal physicians this subject well in advance of the actual moment of necessity, and in particular the problem of acquiring a lethal dose of a drug that will provide a release consistent in quality with the degree of peace (...) and serenity sought in life. It is my hope that we can find a process commensurate with your moral and professional concerns which will allow us to collaborate. (shrink)

I never saw a dead body until my first anatomy class. Today those who have willed their bodies to science receive letters of gratitude, visit with our students, and have their names put up on memorial plaques; but 37 years ago our subjects were derelicts and anonymous old men found dead in flop house hotels. George C, his name written on a tag tied to one toe, lay stretched out on one of the six dissecting tables in the anatomy laboratory (...) that autumn morning when 1 was 22 and beginning medical school. I remember hesitating at the door and then joining my four partners at Mr. C.'s side, trepidation giving way to curiosity, the moment imprinted forever in my memory by the smell of formalin. (shrink)

How can an individual’s Moral Compass address the question of whether or not to help a patient to shorten and end his or her life? Moral Compass has been defined as that set of values and experiences that guides each individual’s decisions and conduct in relation to others and to society. Can a robot be programmed to have a moral compass? If we were only considering rules of conduct, then perhaps yes, that would be possible. We could establish a series (...) of rules and sanctions that a computer assisted robot could rigorously apply for any violation. The state and many religions already do that, and many individuals are quite comfortable with rigorous, unbendable rules. Most rules, however, have exceptions, so perhaps the robots of the future can be designed to be flexible, that is, human. (shrink)

The battlefield and wartime conditions often challenge physicians as to their understanding and commitment to the ethics of medicine. In Homer's Iliad we read of the first physicians on the battlefield before the walls of Troy, the sons of Asclepius, Machaon, and Podalirius. In his 16th century autobiography, Ambroise Paré recounts the first case of battlefield euthanasia of the wounded and of posttraumatic stress disorder and was renowned for his skill and humanity in the care of his soldiers. Dominique Larrey (...) established the principles of triage of the wounded during the Napoleonic wars. It is out of warfare that the Geneva Convention and the Red Cross emerged. But what does history tell us about the ethical dilemmas of the military physician? Should prisoners receive care equal to that given to one's own troops? Can torture be used to extract information that may save lives? Is it ethical to enslave captured soldiers? Is the doctrine of the double effect valid as originally applied to war? Should a physician's ethics require him or her to speak out against perceived violations? This paper explores these issues from a historical perspective and I seek the voices of soldiers in the field wherever possible. (shrink)

At 41 weeks, the patient had been delivered by Cesarean section for failure to progress at Hospital A in the same city. Three days after birth she suffered a respiratory arrest. Resuscitation and ventilator support were initiated promptly but the child did poorly, and shortly after this first arrest, the parents were told by the child's physician that she had no chance of recovery. Nevertheless, the mother continued to insist that the child be kept on a respirator and aggressive support (...) be maintained. (shrink)