Abortion
vs
Manslaughter
To the Editor.\p=m-\DrStubblefield's
ar-
ticle, "Abortion vs Manslaughter" (110:790-791, 1975), addresses the
question of
morality in "viability." Such categorization of unborn human beings as terms
abortion and
of
either "viable"
most
or
"nonviable" proves
arbitrary and, indeed, fails
to
confront the basic issue involved\p=m-\ abortion at any stage terminates a human life. A SPECIAL COMMUNICATION originating from the "other" side of the abortion debate would be greatly ap-
preciated.
WILLIAM V. Milwaukee
DOLAN, MD
In Reply.\p=m-\DrDolan is correct in that my little article did not attempt to deal with the major social and religious issues in the "abortion debate." The purpose of the article was merely to review some scientific data that would aid those physicians who do feel abortion is appropriate and who would like to comply with the law of
the land while serving their patients as best they can. So many pages have been written in the debate as to whether or not a woman should have the right to abort her fetus, and I would only repeat what Dr Kenneth Ryan has recently stated: "Roe vs Wade and Doe vs Bolton affirmed a constitutional right to differ in our personal morality, rather than what many believe was a judgment on the superiority of one moral view of abortion over another."1 In my mind, the decision made by our Supreme Court was the best possible under the circumstances. PHILLIP G. STUBBLEFIELD, MD Boston 1. Ryan KJ: The legitimacy of a diverse soci-
ety. JAMA 233:781, 1975.
Preventing Ulcer Bleeding in Multiple Systems Failure To the Editor.\p=m-\Iwrite concerning Dr Arthur Baue's excellent editorial, "Multiple, Progressive, or Sequential Systems Failure" (Arch Surg 110:779\x=req-\ 781, 1975).
My comments concern the 14 suggested therapeutic options he describes to prevent multiple systems failure in postoperative and accidental trauma patients. I would add a simple and, I believe, empirically logical measure to his list. It pertains to minimizing stress ulcer bleeding\p=m-\a common
terminal event after decom-
pensation of several organ systems. The group of patients under consideration are usually "tubed" (three orifices minimum), wired, ventilated, irrigated, and restrained in an intensive care unit where bright lights and constant monitor beeps stimulate the patient during his conscious periods. In this environment, I would hope that physician and nurse would mercifully administer frequent and adequate doses of morphine or similar analgesics for sleep and relaxation. Analgesia and sedation in this setting may well be equally important as nasogastric suction and antacids for preventing stress lesions in the upper gastrointestinal tract. RODMAN E. TABER, MD Detroit
Consultants We wish to acknowledge with preciation the valued services of
ap¬ our
guest reviewers in the year October 1974 through October 1975.-Eds. Douglass F. Adams Walter F. Ballinger John J. Bergan William S. Blakemore Murray F. Brennan H. Franklin Bunn Richard Burleson Bradford Cannon John J. Collins, Jr Theodore L. Colton Oliver Cope Nathan P. Couch Jan F. Dmochowski
Donald P. Dressler Philip Drinker William S. Dye Edward A. Edwards Vladimir Fencl Robert M. Filler Ruben F. Gittes Robert I. Handin J. Hartwell Harrison Michael Hume Robert Hussey Franz J. Inglefinger Harry . LeVeen J. Drennan Lowell Harry Z. Mellins William C. Moloney Alfred P. Morgan
Downloaded From: http://archsurg.jamanetwork.com/ by a UCSF LIBRARY User on 06/13/2015
Thomas F. O'Brien Basil A. Pruitt Norman Rosenburg William Silen Fiorindo A. Simeone Thomas E. Starzl Paul A. Sugarbaker H. Richard Tyler Leroy D. Van dam Frank J. Veith Gordon C. Vineyard Kenneth Warren John A. Wauldhausen Robert C. Wheeler II Frank C. Wheelock, Jr Richard E. Wilson Robert M. Zollinger
vs
Manslaughter
To the Editor.\p=m-\DrStubblefield's
ar-
ticle, "Abortion vs Manslaughter" (110:790-791, 1975), addresses the
question of
morality in "viability." Such categorization of unborn human beings as terms
abortion and
of
either "viable"
most
or
"nonviable" proves
arbitrary and, indeed, fails
to
confront the basic issue involved\p=m-\ abortion at any stage terminates a human life. A SPECIAL COMMUNICATION originating from the "other" side of the abortion debate would be greatly ap-
preciated.
WILLIAM V. Milwaukee
DOLAN, MD
In Reply.\p=m-\DrDolan is correct in that my little article did not attempt to deal with the major social and religious issues in the "abortion debate." The purpose of the article was merely to review some scientific data that would aid those physicians who do feel abortion is appropriate and who would like to comply with the law of
the land while serving their patients as best they can. So many pages have been written in the debate as to whether or not a woman should have the right to abort her fetus, and I would only repeat what Dr Kenneth Ryan has recently stated: "Roe vs Wade and Doe vs Bolton affirmed a constitutional right to differ in our personal morality, rather than what many believe was a judgment on the superiority of one moral view of abortion over another."1 In my mind, the decision made by our Supreme Court was the best possible under the circumstances. PHILLIP G. STUBBLEFIELD, MD Boston 1. Ryan KJ: The legitimacy of a diverse soci-
ety. JAMA 233:781, 1975.
Preventing Ulcer Bleeding in Multiple Systems Failure To the Editor.\p=m-\Iwrite concerning Dr Arthur Baue's excellent editorial, "Multiple, Progressive, or Sequential Systems Failure" (Arch Surg 110:779\x=req-\ 781, 1975).
My comments concern the 14 suggested therapeutic options he describes to prevent multiple systems failure in postoperative and accidental trauma patients. I would add a simple and, I believe, empirically logical measure to his list. It pertains to minimizing stress ulcer bleeding\p=m-\a common
terminal event after decom-
pensation of several organ systems. The group of patients under consideration are usually "tubed" (three orifices minimum), wired, ventilated, irrigated, and restrained in an intensive care unit where bright lights and constant monitor beeps stimulate the patient during his conscious periods. In this environment, I would hope that physician and nurse would mercifully administer frequent and adequate doses of morphine or similar analgesics for sleep and relaxation. Analgesia and sedation in this setting may well be equally important as nasogastric suction and antacids for preventing stress lesions in the upper gastrointestinal tract. RODMAN E. TABER, MD Detroit
Consultants We wish to acknowledge with preciation the valued services of
ap¬ our
guest reviewers in the year October 1974 through October 1975.-Eds. Douglass F. Adams Walter F. Ballinger John J. Bergan William S. Blakemore Murray F. Brennan H. Franklin Bunn Richard Burleson Bradford Cannon John J. Collins, Jr Theodore L. Colton Oliver Cope Nathan P. Couch Jan F. Dmochowski
Donald P. Dressler Philip Drinker William S. Dye Edward A. Edwards Vladimir Fencl Robert M. Filler Ruben F. Gittes Robert I. Handin J. Hartwell Harrison Michael Hume Robert Hussey Franz J. Inglefinger Harry . LeVeen J. Drennan Lowell Harry Z. Mellins William C. Moloney Alfred P. Morgan
Downloaded From: http://archsurg.jamanetwork.com/ by a UCSF LIBRARY User on 06/13/2015
Thomas F. O'Brien Basil A. Pruitt Norman Rosenburg William Silen Fiorindo A. Simeone Thomas E. Starzl Paul A. Sugarbaker H. Richard Tyler Leroy D. Van dam Frank J. Veith Gordon C. Vineyard Kenneth Warren John A. Wauldhausen Robert C. Wheeler II Frank C. Wheelock, Jr Richard E. Wilson Robert M. Zollinger
