Introduction to the Symposium Issue on Alternative Dispute Resolution Strategies in End-of-Life Decisions

At about 8:30 p.m. on a spring evening approximately twenty-five years ago when I was living in Newton, Massachusetts, our telephone rang. It was the emergency judge on duty that week asking me to go to a nearby suburban hospital to represent a sixty-eight-year-old woman whom I\u27ll call Mrs. P. She had been hospitalized for heart failure and was refusing treatment, saying that she wanted to die with dignity. Mrs. P and her husband had traveled to Boston from her home, a small town in New York about five hours away, to meet their newest grandchild. When I arrived at the hospital, the judge, her clerk, my client\u27s husband, her ten-day-postpartum daughter, and the hospital attorney had already gathered. I was introduced to them and given a bit of background. I learned that the patient had been treated for congestive heart failure for some period of time before her trip to Boston and that she had also received treatment for psychiatric problems. Soon after her arrival in Boston, she took a turn for the worse and went to the hospital. It turned out she had forgotten to bring her heart medication with her, but did not tell anyone until she became weak and disoriented. Earlier in the day her vital signs had begun to worsen. She was refusing intramuscle injections of medication that had a high likelihood of saving her life and having her up and about in a short time. In addition, the nurses reported that she had been a difficult and demanding patient. According to the physicians, without treatment she was likely to die within the next twenty-four to forty-eight hours