Advances in medical technology generally have outpaced the ability of the legal system to respond effectively to the unique medico-legal problems that arise in the context o f care and treatment of terminally ill patients. These technological advances have enabled medical professionals to sustain critical bodily functions of terminally ill patients using an array of life support systems so as to increase the likelihood of a lingering death. This dilemma has spawned substantial public debate and an abundance of medical, legal, ethical, and religious commentary about the rights of terminally ill patients in determining the time and manner of death. In this regard, considerable attention has been focused on the role of the judiciary in the exercise of these rights (1). The possi bility of being maintained in limbo, in a sterile room, by machines controlled by strangers, has led to the appropriate social observation that the struggle of medical science and technology against death has resulted in its own peculiar horrors (2, p. 531). Yet, to the extent that it is the individual who is the subject of the medical decision in this final context, it must be the individual who has the final say. This must be the assumption in a system of government that endeavors to provide the greatest possible protections to individual pursuit of
self-determination (3, p. 706). Accordingly, in an effort to insure the right of terminally ill patients to choose natural death, a significant number of courts and legislatures have taken affirmative steps to establish comprehensible legal standards against which these important decisions can be made. While there remains a substantial burden upon the judicial and legislative systems to re solve these particular medico-legal problems, there have been some efforts to provide reasonable guidance to patients, families, health care professionals, and health care institutions confronted with difficult decision-making responsibilities in these circumstances. The nature and scope of current common law (courtmade law) and legislative developments in this complex and at times perplexing area of medical law is examined in this essay.