"She looked at me and said 'Why can't they just let the poor man die.' He was a terminally ill patient with diffuse cancer. He was writhing in pain and gasping. Now should you do everything possible to resuscitate a patient in that condition?"

Previously, decisions to resuscitate were handled informally by a physician, but now recent controversies have created the necessity to "develop a methodology which allows us to make a decision that is fair, just, judicious and above board," Rabkin said.

Complexities

The problem is complex, he said, and it is difficult to decide exactly what is a moral or social question and what is a medical or clinical question.

All hospital officials contacted said that the question of responsibility for these life-and-death decisions is far from being resolved and that, in fact, the problem of accountability will continue to grow.

Rabkin's proposals allow the doctor and the patient--with the consent of an advisory committee--to agree beforehand that, after a certain point of deterioration of the patient's physical condition, the doctors will not make resuscitation attempts.

Rabkin's original guidelines also allow the family of incompetent patients to make a similar decision. This is the portion of the guidelines which the recent court decision affects