FOREWORD

dilemmas that accompany such awesome power.

If a life can be saved now by an artificial organ, whose life should it be, and on

what basis should we decide? If a dying individual can be sustained on a respirator

to a point where the distinction between life and death is blurred, how shall we

examine when the border of no return has been passed, and by whose criteria and

under whose authority will treatment be terminated? When antisepsis permits us to

do unheard-of surgery of sweeping and dramatic power to save the life of a cancer

patient, how shall we decide if the radical deformity which extends life is worth the

extra days of living for the mutilated patient? How are we to equate the number of

clays a patient survives with the quality of those days?

These are only some of the tragic dilemmas considered in this book. We are all

now-by demand, not choice--philosophers in pursuit of an evasive truth.

Medicine has forced a renewed interest in ethics, and all of us--physicians,

philosophers, and citizens who inevitably will be caught up in these decisions--are

groping for answers.

The answers do not come easily, and each resolution involves a compromise in

which something treasured--privacy, autonomy, days of life--may have to be

abandoned to preserve something else equally treasured--a sense of justice,

human dignity, the common good. I tend to distrust anyone who is comfortable with

any decision in these areas. They are hard choices, and most of us come to our

conclusions reluctantly, with a sense of anguish and humiliation. And so it should be

when one deals with life and death.

The cases offered here are presented in an adversarial way to sharpen your

awareness of the dilemmas involved. Every attempt has been made to play with a

fair deck, by having the strongest and best case made on each side of the issue. It is

hoped that by the time you have finished this book you will be fully aware of the

extraordinary extent of the problems that have been created by the Biological

Revolution--that you will be informed of the major decisions that you, not some

experts, will be called upon to make in the not too distant future, either directly in

your personal life or through your legislative representatives. Finally, it is hoped

that, as a testament to any good educative effort, on completion of this book you will

be left with fewer, rather than more, answers.

Willard Gaylin, M.D.

President, The Hastings Center

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