Medical Futility Decisions-Reply

Nancy S. Jecker, PhD; Robert A. Pearlman, MD, MPH
Arch Intern Med. 1993;153(4):533. doi:10.1001/archinte.1993.00410040090017.
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We appreciate the letter of Oles discussing the appropriate role of patients' religious beliefs in determining the course of medical care. However, we do not agree with her conclusion that reaching a broad community consensus is "dangerous to the moral fiber of society" due to the "secular, changeable value system of contemporary America." Nor do we concur with Oles' position that "taking the decision regarding life-prolonging medical treatment out of the patient's hands... denies the patient the right to practice his religion."

In our estimation, religious teachings are themselves extraordinarily difficult to interpret and apply in specific, medical contexts. Further, Judeo-Christian and other religious values are not immutable, but are subject to the same changes of interpretation as secular teachings. Finally, and most important, the separation of church and state in our society limits the proper role of religious values in public policy formation. In our society, standards of medical


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