Our Hands Are Tied: Legal Tensions and Medical Ethics

commitment weakens respect for the legitimate risk management guidance that should be taken seriously as the basis for decisions and actions.

Ideally, the growing involvement of risk managers and in-house legal counsel within modern health care settings ought to add to, rather than detract from, physicians' capacity to provide ethically acceptable medical care to patients. The humanization of medicine demands that strategies be developed and implemented to enhance and magnify the salutary role these actors could play and to rectify the perverse influences they often currently exert.

Asch D. A., Hansen-Flaschen J., & Lanken P. N. ( 1995). "Decisions to limit or continue life-sustaining treatment by critical care physicians in the United States: Conflicts between physicians' practices and patients' wishes." American Journal of Respiratory Critical Care Medicine, 151, 288-292.

Barnett T. J. ( 1991). "Lawyer's advice [Letter]." Annals of Internal Medicine, 115, 409-410.

Harpster L. M., & Veach M. S. (Eds.). ( 1990). Risk management handbook for health care facilities. Chicago, IL: American Hospital Publishing.

Hoffmann D. E. ( 1991). "Does legislating hospital ethics committees make a difference? A study of hospital ethics committees in Maryland, the District of Columbia, and Virginia". Law, Medicine and Health Care, 19, 105-119.

Hoffmann D. E., Boyle P., & Levenson S. A. ( 1995). Handbook for nursing home ethics committees. Washington, DC: American Association of Homes and Services for the Aging.

In re Quinlan ( 1976), 70 N.J. 10, 355 A.2d 647, cert. denied, 429 U.S. 922.

Macklin R. ( 1993). Enemies of patients. New York: Oxford University Press.

Minogue B. ( 1996). Bioethics: A committee approach. Sudbury, MA: Jones and Bartlett Publishers.

Mitchell S. M. ( 1997). "Book review of Bioethics: A Committee Approach by B. Minogue". Journal of Ethics, Law, and Aging, 3( 1), 62-66.

Phillips D. F. ( 1996). "Ethics consultation quality: Is evaluation feasible?" Journal of the American Medical Association, 275, 1866-1867.

Quill T. E. ( 1993). Death and dignity: Making choices and taking charge. New York: W.W. Norton & Company.

Weisbord A. J. ( 1986). "Defensive law: A new perspective on informed consent". Archives of Internal Medicine, 146, 860-861.

-64-