The role of law in the patient-physician relationship

Free or bound decision, individual responsibility or professional ethical control, conduct according to conscience or to legal directives: these buzzword dyads indicate just a few of the issues with which a physician sees himself confronted in his decision-making. And indeed not only in cases of extraordinary procedures, such as reanimation and transplantation, sterilization and fertilization, abortion and perinatology, psychosurgery and sex-change operations, experiments on human subjects and gene manipulation; but also in the day-to-day routine of patient referral or non-referral, or of continuation or termination of treatment, a physician faces the dilemma of whether or not he may take advantage of opportunities that present themselves. These problems could be summed up under the rubric of the justifications and limits of 'medical discretion'. This, however, is certainly wide open to misunderstandings because, in this way, the doctor appears to usurp an exemption for himself which ethicists and legal experts do not believe they can grant him unconditionally. In order to elucidate this problem, two issues are subject to closer analysis. First, the widespread prejudice that medical conduct is determined largely by impartial medical facts for which the establishment of norms is fundamentally elusive: this issue will be disputed on the basis of problems determining the concept and criteria of death and the appropriate termination of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)