NATIONAL CENTER FOR STATE COURTS (NCSC)
300 Newport Avenue
Williamsburg, VA 23184

(804) 253-2000

Organizational overview:  The NCSC was founded in 1971 to provide assistance to state and local trial and appellate courts by compiling national statistics, conducting studies, and acting as a clearinghouse for the exchange of court-related information.  In 1992, the NCSC issued what became a well respected and widely cited treatise on the role of the state courts in end-of-life decision making entitled Guidelines for State Court Decision Making in Life-Sustaining Medical Treatment Cases.  More recently, the NCSC completed a three-year-long process of writing a follow-up report directed toward caregivers with publication of Resolving Disputes Over Life-Sustaining Treatment: A Health Care Providers Guide  (Hafemeister and Hannaford 1996).  The group involved in this later project consisted of four judges, five lawyers, two ethicists, three physicians and a registered nurse, all of whom had professional experience in end-of-life decision making.  Additional input was solicited from other health care professionals, clinical social workers, administrators, legal counselors, and those involved with pastoral care.  Input from patients and family members was also solicited. 

Position on tube feeding at the end of life

Artificial nutrition and hydration are forms of medical treatment that should be governed by the same practices and policies that apply to other forms of medical treatment (Hafemeister and Hannaford 1996:13). . . .  Although issues involving artificial nutrition and hydration are often presented more emotionally, from a moral and legal standpoint, they raise the same questions as do other forms of medical treatment (NCSC 1992: 145). . . .   Life-sustaining medical treatment can take many forms, from something as simple as a penicillin pill to something as complex as a respirator, depending upon the patient's circumstances. It is these circumstances that are important in making life-sustaining medical treatment decisions and the potential benefit to the patient, and not labels such as 'extraordinary,''ordinary,' and 'heroic,' which are of little value in actually making the life-sustaining treatment decision.  Indeed, they tend to confuse the decision making (NCSC 1992: 144). 

Citations

Hafemeister, Thomas L. and Hannaford, Paula L.  1996.  Resolving Disputes Over Life Sustaining Treatment: A Health Care Provider's Guide.  Williamsburg, VA: National Center for State Courts.

National Center for State Courts (NCSC).  1991. Guidelines for State Court Decision Making in Life-Sustaining Medical Treatment Cases. 2nd ed. Williamsburg, Va.: NCSC.