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To the Editor: In their editorial, "The Neurologist and the Dying Patient," Bernat et al. [1] make a number of serious errors in fact and ethical reasoning. These mistakes raise questions about the propriety of amateur Academy ethicists dictating ethical guidelines to members. Furthermore, their recommendations, if followed, will lead to grave consequences for patients, physicians, and society.
The authors state that patients have the right to refuse life-sustaining treatment. They claim there is a strong consensus that artificial hydration and nutrition are medical therapy and that "neurologists should respond" to a patient's or surrogate's refusal of food and water. However, the claim is not documented and represents only the opinion of the authors. Contrariwise, the Chief Justice of the Missouri Supreme Court stated that, "common sense tells us that food and water do not treat an illness, they maintain life." [2] More importantly, ethics is not a matter of majority rule, but is based on a reasoned analysis of the facts. Furthermore, the authors neglect to discuss the physician's rights. An a …
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