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EDITORIAL

Nancy Cruzan and the Withhold Versus Withdraw Dilemma
William H. Colby

On March 9, 1988, we started trial on Nancy Cruzan’s case in the three-story limestone courthouse on the town square in Carthage, Missouri. One of the many issues we’d end up talking about in the days and months of legal proceedings that followed was withholding versus withdrawing a feeding tube, and how those two acts should present the same legal and ethical challenge. We cited pages 75–77...

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What to Expect When Expecting CRISPR Baby Number Four
Christopher Thomas Scott & Cynthia Selin

In the wake of reports that a Chinese biophysicist, He Jiankui, used a genome editing technology, CRISPR/Cas9, to modify the CCR5 gene in viable human embryos, the criticism from the international scientific and bioethics communities has been swift and unrelenting. The overwhelming conclusion is that Dr. He’s procedure was deceptive, violated Chinese law, flaunted international ethical norms, an...

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Female Genital Cutting (FGC) and the Cultural Boundaries of Medical Practice
Rosie Duivenbode & Aasim I. Padela

In April 2017, Dr. Jumana Nagarwala, at that time an emergency medicine physician at Henry Ford Hospital in Detroit, MI, was arrested and jailed. Together with seven others, she will be among the first persons to be tried under the U.S. federal “Female Genital Mutilation” (FGM) law. While those involved are awaiting their trial, we have observed that the strategic use of stigmatizing terminol...

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Target Article

Withholding and Withdrawing Life-Sustaining Treatment: Ethically Equivalent?
Lars Øystein Ursin

Withholding and withdrawing treatment are widely regarded as ethically equivalent in medical guidelines and ethics literature. Health care personnel, however, widely perceive moral differences between withholding and withdrawing. The proponents of equivalence argue that any perceived difference can be explained in terms of cognitive biases and flawed reasoning. Thus, policymakers should clear away...

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Withdrawal Aversion and the Equivalence Test
Dominic Wilkinson, Ella Butcherine & Julian Savulescu

If a doctor is trying to decide whether or not to provide a medical treatment, does it matter ethically whether that treatment has already been started? Health professionals sometimes find it harder to stop a treatment (withdraw) than to refrain from starting the treatment (withhold). But does that feeling correspond to an ethical difference? In this article, we defend equivalence—the view that ...

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