Legal trends in bioethics.

Directives given in advance of need and substituted consent cases include: the New York trial court that denied the request of a patient's son for an order revoking the health care proxy his mother had given to his sister, the tape-recorded telephone conversation between the son and his mother was ruled to be insufficient evidence of the mother's desire to revoke the proxy, the mother was not fully responsive or articulate enough to convey her thoughts concerning the proxy. By the end of 1991, all states except Pennsylvania and Nebraska had enacted some form of advance directive legislation. The article highlights legislation from Arizona, California, Connecticut, Illinois, Hawaii, Louisiana, Nevada, New Hampshire, New Jersey, North Carolina, Ohio, and Virginia. A study from Mount Sinai School of Medicine in New York comparing the views of surrogate decision makers with the decisions of currently competent, chronically ill, elderly patients found that surrogates were unable to predict the patients' wishes about resuscitation. AIDS developments include: The Centers for Disease Control (CDC) abandoning its plan to publish a list of categories of exposure-prone invasive procedures. The appropriation bill for the Treasury, Postal Service and General Government requires that states adopt CDC's guidelines or their equivalent within one year, or risk losing all Public Health Service funding. The article highlights 2 court cases relating to AIDS questions. The section on assisted suicide discusses the medical license suspension of Jack Kevorkian and his "suicide" machine. On the discontinuation of treatment, the authors discuss several court cases. patients' rights examples include the Washington State decision imposing a duty on the examining doctor to disclose abnormal test results to the person being examined, regardless of whether a doctor-patient relationship exists. Other topics include reproductive issues, the right to treatment, and treatment refusals.