s, according to the AMA, to a "double effect," i.e., giving such high drug dosages for pain relief that they also end the patient's life (Glasson, 1994, pp. 93-4).
The custom and practice of withholding food from comatose terminal patients appears to have been in place for nearly 20 years (Weiser, 1983). In 1987, when New York formally regulated Do-Not-Resuscitate (DNR) orders by doctors, it turned out that advance-consent DNR orders had been de facto in place for years (McClung & Kamer, 1990). It was estimated in the early 1990s that some 70% of deaths in all modern hospitals were the result of conscious decisions to stop medical treatment (Walters, 1992). Some form of assisted suicide was considered a commonplace of American health care by the mid-1990s (Cotton, 1995). But the trends have not been all in one direction. Further, end-of-life law has not been unambiguous. The Patients' Self-Determination Act of 1990 specifically guarantees patients the right to refuse medical treatment and requires hospitals receiving federal Medicare and Medicaid fun
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