The Law and Bioethics of End-of-Life Decisions

Nafziger examines the law of bioethics of end-of-life decisions in the US. As lives ebb and often difficult decisions need to be made accordingly, what matters throughout the federal system of the US generally is not substantive law and policy of the federal government. Instead, the laws and policies of the constituent states and other subnational entities are instrumental. The federal government's role has been largely to ensure that these entities protect and promote personal autonomy in making end-of-life decisions within the bounds of the public welfare. A single act of Congress, the Patient Self Determination Act of 1990, made this clear. The basic intent of this law was to help ensure an opportunity under state or other subnational authority for adults to express their desires about medical treatment in advance of the need for it and to educate the public about such advance directives.