SOURCE: Alice Herb, attorney, medical ethicist and member of the faculty in the Graduate Program in Health Advocacy at Sarah Lawrence College (Bronxville, N.Y.) In 1980, Sarah Lawrence established the nation's first master's degree program in Health Advocacy. It has provided a leadership role in defining this new field and in educating professionals to improve health care and ensure access to an increasingly complex system.
On March 27th members of Congress from both parties agreed the legislative branch has a role to play in end-of-life issues such as the Terri Schiavo case. Previously the Republican-controlled House had passed a bill that would allow federal courts to review such cases. They have now been joined by Representative Barney Frank, Democrat of Massachusetts and Senator Tom Harkin, Democrat of Iowa, among others, to look into end-of-life decision-making issues in an effort to add clarity for those struggling with such issues, particularly when the patient's wishes are disputed.
"Congressional hearings could be helpful, if they provided careful consideration of guidelines that would keep the law in line with the ethics principles of self determination and the best interest of the patient," says Alice Herb. "What the Schiavo case has shown is that we do need to consider carefully the most vulnerable patient - the one who has no one to speak for her or whose family is split by differences of opinions. But this does not mean inviting special interests, politicians or others to impose their values on the family. We also need to ensure that the person who has the capacity to make decisions for herself should be able to have those decisions respected including, terminating treatment at any time. And in cases where the person is now incapacitated and has left a living will or end of life advance directive she should have her wishes respected unless there is persuasive evidence that indicates the patient has changed her mind at the last moment." Herb is a graduate of Syracuse University (B.A.) and received her J.D., LL.M. degrees from New York University School of Law. She is on the faculty in the Graduate Program in Health Advocacy at Sarah Lawrence College, and assistant clinical professor of family practice and humanities in medicine, SUNY Health Science Center at Brooklyn. Formerly ethics consultant to The Brooklyn Hospital Center (1994-2003); special interest in clinical ethics, particularly in channels/barriers between health care professionals and patients/families; the role of palliative care in a high-tech environment and the continuing dilemma in human subject research; currently involved in a palliative care initiative of changing institutional culture to accommodate an alternate treatment approach and an analysis of a clinical ethics program at an acute care facility.
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