Endings and Beginnings: Law, Medicine, and Society in Assisted Life and Death

As society struggles to cope with the many repercussions of assisted life and death, the evening news is filled with stories of legal battles over frozen embryos and the possible prosecution of doctors for their patients' suicide. Using an institutional approach as an alternative to the prevailing rights based analysis of problems in law and medicine, this study explains why society should resist the tendency to look to science and law for a resolution of intimate matters, such as how our children are born and how we die. Palmer's institutional approach demonstrates that legislative analysis is often more important than judicial analysis when it comes to issues raised by new reproductive technologies and physician-assisted suicide. A reliance on individual rights alone for answers to the complex ethical questions that result from society's faith in scientific progress and science's close alliance with medicine will be insufficient and ill-advised. Palmer predicts that the key role of the family as a societal institution will mean that questions of assisted reproduction will be resolved more in response to market forces than through legal intervention. However, he does support a strong role for legislatures in decisions involving the physicians' role in our deaths. These findings are based on the differing views of the Supreme Court justices in these matters: a tendency to protect family formation from state interference (as in abortion decisions), but support of a legislative obligation to control medicine (assisted suicide). According to Palmer, recent Supreme Court decisions on physician assisted suicide usher in a new era in how legal institutions will resolve biomedical dilemmas.

Table of Contents:
Introduction The Role of Law in Our Intimate Lives Science in the Service of Medicine and Law Assisted Reproduction: Do We Need a Legislative Definition of the Family? Creating One's Own Death: Is There a Constitutional Right to Die? Chronically Ill or Terminal?: A Question for Legislatures The Role of Physicians in Generational Continuity The Role of Physicians in Our Dying: Relievers of "Suffering"? Physicians' Constitutional Rights: Relievers of "Pain"? Physicians' Legislative Privileges to Assist Life or Death Professionalism, Autonomy, and Medical Progress Selected Bibliography Index

About the Author :
LARRY I. PALMER is Professor of Law at Cornell Law School in Ithaca, New York, where he has taught courses on law and medicine for many years. He is the author of Law, Medicine, and Social Justice (1989) and numerous journal articles dealing with law, medicine, and policy. He is executive producer and author of the study guide for the award-winning educational video, Susceptible to Kindness: Miss Evers' Boys and the Tuskegee Syphilis Study (1994).

Review :
"A reasoned and thoughtful guide to some of the toughest ethical and legal challenges... about how to live and how to die. [The author] carefully shows how to chart a course between what are the most intimate and personal of decisions and the construction of sound social and public policies."-Arthur Caplan Trustee Professor and Director, Center for Bioethics University of Pennsylvania Author, The Ethics of Organ Transplants "An important book about a series of pressing social concerns: How, if at all, should the law regulate reproductive technology? What are the implications, both practical and theoretical, of institutionalizing choice in dying?' Palmer situates each of these concerns--each of these bioethical questions--within a social context, demonstrating that they must be discussed in the context of the institutions (law, medicine, the family, religion) that regard them as crucial to the preservation of culture. Everyone involved in these institutions should read carefully Professor Palmer's insightful and provocative book."-Janet L. Dolgin Distinguished Professor of Constitutional Law Hofstra University, School of Law "It is the very essence of medicine to attend life's entrances and exits....Palmer in Endings and Beginnings....provides an in depth look at the interface of medicine and law at these times of passage....[It] is not only relevant to the specialist reader of the law, but to the practicing physician and medical student as well."-Richard Bronsons Associate Professor and Director Department of Obstetrics and Gynecology SUNY Stony Brook Senior Editor of Reproductive Immunology "Larry Palmer forces us to think in new ways about how law and medicine intersect at the beginning and end of life. He shows that decisions for newborns and people with terminal illnesses must not be permitted to rest solely on either medical judgement or legal imperatives, that they inevitably -- and rightly - entail religious convictions, individual values, and family circumstances. Endings and Beginnings is an important and provocative book."-Daniel J. Kevles Professor of The Humanities California Institute of Technology author of In the Name of Eugenics: Genetics and the Uses of Human Heredity, The Physicists: the History of A Scientific Community in Modern America, The Baltimore Case: A Trial of Politics, Science, and Character .,."Palmer has done us a service in showing how radically we will need to re-think old understandings about the relationships between patients and their physicians."-The Law and Politics Book Review ?...Palmer has done us a service in showing how radically we will need to re-think old understandings about the relationships between patients and their physicians.?-The Law and Politics Book Review ?[T]he analysis of the court decisions, the interpretation of the dilemma from the perspective of differing stakeholders, and the perspective of the differences in legislative versus judicial solutions are enlightening. Graduate students; professionals.?-Choice "ÝT¨he analysis of the court decisions, the interpretation of the dilemma from the perspective of differing stakeholders, and the perspective of the differences in legislative versus judicial solutions are enlightening. Graduate students; professionals."-Choice ..."Palmer has done us a service in showing how radically we will need to re-think old understandings about the relationships between patients and their physicians."-The Law and Politics Book Review "[T]he analysis of the court decisions, the interpretation of the dilemma from the perspective of differing stakeholders, and the perspective of the differences in legislative versus judicial solutions are enlightening. Graduate students; professionals."-Choice