The case of Helga Wanglie: a new kind of ''right to die'' case

Article Abstract:

An unusual right-to-die case was recently heard, involving an 86-year-old woman, Helga Wanglie, who had been in a persistent vegetative state for more than one year. Her family wanted her life to be maintained on a respirator, while physicians argued that such treatment was inappropriate. The court ruled for the family; Mrs. Wanglie died three days after the court's decision. This decision was consistent with others that have been reached in right-to-die cases, in that the family was allowed to make the crucial decision. The right of competent adults to refuse medical care has been supported in many cases, but situations where people become incompetent without having left clear instructions regarding life-sustaining treatment are more complex. In spite of a growing awareness about the importance of living wills and other types of advance directives, many people do not provide guidance to their families. When families are allowed to decide about treatment in such cases, the treatment is supposed to be in the patient's best interests and should be a choice that 'reasonable' adults might make in the same situation. In the Wanglie case, an argument could not be made that the patient's best interests were violated by continuing her on the respirator, since Mrs. Wanglie was incapable of suffering. The arguments of the medical facility where Mrs. Wanglie was hospitalized are discussed in another article in the August 15, 1991 issue of The New England Journal of Medicine. While most people state that they would not want their lives to continue if they fell into a persistent vegetative state, all people do not feel this way. Overriding the objections of family members who want someone kept alive would be callous. The important aspect of the Wanglie case is that it affirms the right of the family to make such decisions, rather than supporting any particular position regarding a patient's right to die. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cases, Laws, regulations and rules, Medical ethics, Right to die, editorial, Wanglie, Helga

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Evaluating the health risks of breast implants: the interplay of medical science, the law, and public opinion

Article Abstract:

The case against breast implants illustrates the growing dissatisfaction among the public with the scientific method. When Connie Chung interviewed several women in 1990 who claimed their autoimmune diseases had been caused by their breast implants, public fear took over. One year later, a jury awarded $7.34 million to a woman who claimed that her breast implants had led to connective tissue disease. After the FDA banned silicone breast implants in Apr, 1992, tens of thousand of lawsuits were filed against Dow Corning, a major implant manufacturer. In 1994, implant manufacturers agreed to a huge settlement, but so many women registered for awards, Dow Corning filed for bankruptcy. In 1995, a woman successfully sued Dow Chemical, Dow Corning's parent company, even though several large epidemiologic studies had shown there was very little risk associated with breast implants. Many jurors rejected the scientific studies as irrelevant. Extensive science education beginning in grade school and better science journalism could improve the public's perception of science.

Risk factors, Medical research, Public opinion, Connective tissue diseases, Breast implants

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Editorials and conflicts of interest

Article Abstract:

The editors of The New England Journal of Medicine have restated their policy on the publication of editorials to avoid conflicts of interest. The journal published a scientific report in its Aug 29 issue linking primary pulmonary hypertension with the diet pill dexfenfluramine. They invited two scientists to comment on the study in an editorial but were not aware that one of the scientists had an ongoing consultancy with the company that distributes another diet pill called Redux. This was in violation of the journal's policy that forbids any scientists from writing editorials about a product if they have a relationship with the company that makes it.

Editorial, Publishing industry, Ethical aspects, Medical publishing, Editorials, The New England Journal of Medicine (Periodical)

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