ithdrawal of medical treatment for dying patients arose out of concerns regarding the complexity, efficacy and humaneness of the decision-making process which has evolved for handling such situations since the mid-1970s. Urofsky says that "at the end of the twentieth century before one can leave this world, he or she may find it necessary to traverse a bewildering legal, moral, and medical maze." What was once a decision, however painful and difficult, made by a few people, the patient, his or her physician and close family members, became a subject of national controversy. Before one consider how to improve the existing decision-making process, it is necessary to understand how and why that process has evolved in the United States.
It is estimated that in 1990 as many as 25,000 "permanently unconscious patients were then . . . in hospitals throughout the country," many of whom had not in advance made their wishes clear and many others of whom are either in a persistent vegetative state (PVS), brain dead or suffering from terminal illnesses whic
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