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In the current era of cost-containment, Congress may reconsider its support for the End-Stage Renal Disease Program. Substantial reductions in funding for this program could be made by eliminating non-beneficial, marginally beneficial, and relatively inefficient modes of treatment. These measures, however, will only postpone the inevitable day when clearly beneficial treatment must be withheld.

Current federal policy, as reflected in the final Baby Doe rule, will have a chilling effect on the ability of doctors to care appropriately for severely disabled infants. The policy threatens to prolong life unjustifiably for such infants. It will force physicians to violate a duty to do no harm without compensating benefit. And it raises serious problems for the just distribution of health care.

KIE: Cohen reviews two collections of essays on ethical issues in critical care medicine: Ethics and Critical Care Medicine, edited by John C. Moskop and Loretta Kopelman (D. Reidel; 1985), and "Ethical Moments in Critical Care Medicine," a symposium issue of Critical Care Clinics, edited by James P. Orlowski and George A. Kanoti (1986 Jan; 2(7): 189 p.). Some of the topics discussed by the contributors include physician beneficence vs. patient autonomy in critical care decision making; the pressures created by the "rescue ethos" of the critical care setting; the selection of patients for admission to intensive care; the equitable distribution of critical care resources; and the increasing need to factor costs into treatment decisions. E. Cassell, E.D. Pellegrino, J. Katz, D. Walton and N. Donen, J. Moskop, J. Perrin, H.T. Engelhardt, R. Veatch, J. Paris and F. Reardon, S. Youngner, and S. Imbus and B. Zawacki are among the essayists.