Dr. David Jackson is one of this country's leading medical ethicists. He is director of the Center for the Critically Ill and professor of neurology and medicine at the University Hospitals of Cleveland. He was a fellow of the Kennedy Institute of Ethics and Research at Georgetown University.
He has helped establish a multi-disciplinary staff including psychiatrist, philosopher and social worker in addition to medical professionals, and has helped devise a series of checks to determine the authenticity of patient or family wishes to forego heroic measures, the single trickiest ethical problem. "The instantaneous expression of wishes can lead you down a very wrong path . . . I've seen so many patients change their attitudes as death becomes not an abstract consideration but an imminent reality."
His checklist, briefly, is: ambivalence, fear, depression and "what I call the misapplication of the Golden Rule. That is not an adequate rule of thumb."
He cannot accept the Hemlock way because "although they speak to a concern, they do it in a way that leads us down a slippery slope with no guaranteed break. If it's all right for a cancer patient, what about the elderly, or a Tay-Sachs infant . . . "
"Our concern is the quality of both living and dying, the humanity involved in both the living and dying process.