5; by 2030 an estimated 20 percent. About 70 percent of those who die in institutions "die as a result of someone's decision to withdraw or withhold life-sustaining treatment."
Americans are living longer, in large part because of advances in medicine. Kadish says that "today, chronic regenerative diseases such as cancer, heart disease and cerebrovascular disease have become predominant, accounting for approximately seventy percent of all deaths in the United States." These same medical advances, including organ transplants, organ repairs, organ substitution (respirators, ventilators and renal dialysis machines), drugs and breakthroughs in genetic and biotechnology, offer the promise of significantly extended life spans. Urofsky reported in 1994 that "the rate of discovery was not slowing down, and the half life of new techniques and medicines might be no more than five or six years.
People who would have died from injuries or diseases or just the ravages of age can now be kept alive." He says that "they are not functional or independent, but life-support systems can keep their bodies going even if they are not conscious or have lost all mental powers. Even if their brains cease to function, the machines keep them breathing and their hearts pumping blood to inert limbs."
While most cases relate to the treatment of the dying aged, all age groups can be affected since death can strike at any time. Another major group affected is newborn infants. According to Urofsky, "seriously deformed infants who normally would have died within hours or days of birth can now be 'saved,' kept alive, although little can be done to repair their physical defects or remedy their mental retardation."
Growing Complexity of the Decision-Making Process
The growing sentiment in favor of the use of techniques of mediation during the 1980s and since as an adjunct and aid to the making of decisions concerning the provision, withholding or w...