European Stars And Stripes (Newspaper) - March 17, 1986, Darmstadt, Hesse                                Monday March 17, 1986 the stars and stripes Page 5 Ama panel oks withholding treatment action Veth Ca or patients in irreversible comas new Orleans not the american medical. Association s judicial Council says it would be ethical for doctors to withhold All Means of life prolonging medical treatment including food and water from patients in irreversible comas even if death is not imminent. The withholding of such therapy should occur Only when a patient s coma is beyond doubt irreversible and there Are adequate safeguards to confirm the accuracy of the diagnosis the Council said. The opinion which was handed Down saturday could affect at least 10,000 americans who Are in irreversible comas according to or. Nancy w. Dickey chairman of the Council. The Council s opinion which in effect bears the approval of the medical organization was issued at a meet ing on ethics and Medicine co sponsored by the Ama and the Hastings Center a research and education Institute at Hastings on Hudson . Under the association s bylaws the judicial Council s opinions cannot be overruled by the Ama s House of delegates or its officers and can Only be changed by the Council itself according to Toba Cohen a spokesman for the Chi Cago based organization. The opinion of the 271,000-member association does not constitute a hard and fast Rule for doctors but it opens the Way for them to withdraw life prolonging treatment with less fear of being taken to court and to use the opinion As a defense if they Are challenged. Dickey a family physician in Richmond Texas said the decision was arrived at unanimously by the seven member Council after discussions Over 18 months. Busiest Day since Scarf of strike under the new ruling Dickey said the physician is under no obligation to Stop therapy. She emphasized that the ruling does not say that a physician has to pull out ivs or feeding tubes. The ruling states that doing so is not unethical and is a decision that each physician and each patient s family and Legal guardians would address on a Case by Case basis she said. This is not a decision lightly entered into Dickey said. She said in an interview that the new opinion is a clarification and expansion of the Council s previous opinions on terminal illness. Those opinions said in part that for humane reasons with informed consent a physician May do what is medically necessary to alleviate severe pain or cease or omit treatment to let a terminally ill patient die but he should not intentionally cause  although Many physicians have interpreted the older opinion to mean they could withhold food and water others did not. The Issue has been controversial and a focus of court decisions. But Dickey said the decision was not directed at any individual Case. Even with the new ruling Dickey said there will be some doctors who would choose to believe that withholding food and water would intentionally cause  the new opinion also said life prolonging medical treatment includes medication and artificially or technologically supplied respiration nutrition or hydration. In treat ing a terminally ill or irreversibly comatose patient the physician should determine whether the benefits of treat ment outweigh its burdens. At All times the dignity of the patient should be  Dickey said that what constituted adequate safeguards to confirm the accuracy of the diagnosis As the new ruling states would depend on decisions made by physicians in individual cases. Such safeguards would undoubtedly include repeated neurological examinations and brain wave tests and other medical studies. There is no medical definition of adequate safeguards Dickey said and there is no checklist that doctors would have to fill out in each Case. Or. William s. Hotchkiss chairman of the Board of trustees of the Ama said that the new opinion is an important decision that attempts to keep Pace with the technology available to physicians today and is consistent with the recommendations made by the president s commis Sion on  the commission officially named the commission for study of ethical problems in Medicine and biomedical and behavioural research said two years ago that family Mem Bers or others acting on behalf of such patients should be allowed to halt medical treatment that keeps them alive. The commission also said that the terminally ill patients themselves should be allowed to halt treatment if they were mentally competent. Many states have tried to Clear the Issue of treating the comatose who Are terminally ill by acting to define brain death. In at least 37 states Legislatures or courts have worked out a definition modelled along the lines of a recommendation released by the commission that said a person is brain dead when he has suffered irreversible cessation of the functions of the entire brain including the brain  Twa flying 75 percent of schedule new York a trans world air lines flew about 75 percent of its scheduled flights saturday its busiest Day since the beginning of a strike by flight attendants a company spokesman said. The 5,700-member Independent federation of flight attendants meanwhile complained to the Federal aviation administration that Twa s replacement flight attendants Are violating Faa regulations. The Union said the Faa had taken a Cavalier attitude to its charges that re placement Crew members had been seen drinking alcoholic beverages prior to flights and that planes had taken off without the Cabin doors secure. Twa disputed charges by the Union that the Faa had found some of the 1,500 newly hired flight attendants were inadequately trained and passenger safety was threatened up reported. All i know is that Twa chairman Carl Icahn said late last night if there have been any problems the Faa has t contacted us said Twa spokesman Daniel Kemnitz. They Haven t stopped a  the Union released a statement Friday from Kansas City saying Faa inspector William Francis had in fact told Twa to cease using unqualified Crew members As of March 11," up reported. The order referred to Twa s alleged practice of using flight attendants with just five hours of flight time the Union said. Faa spokesman Fred Farrar said sat urday in Washington that Twa was warned that it had been giving its new flight attendants even before the strike Only half the training required. He said the airline had misinterpreted the regulations and immediately complied after the warning up reported Sally Mcelwreath a Twa spokeswoman said the airline s training of replace ments was in full compliance with Faa regulations. Twa has been using 1,750 newly hired workers and 1,500 company employees on loan from their other jobs with the airline since the strike began March 7, the airline said. The airline s planned schedule for sat urday called for 431 flights including 45 International departures and trips to every City in its system said Twa spokesman Dan Kemnitz. The schedule represents 74.2 percent of . Airline safety major regularly scheduled carriers traffic volume air Carrier inspectors 700 675 650 billions of passenger Miles number of workers 1978 79 80 81 82 83 84 85 1978 79 80 81 82 83 84 85 deaths fatal accidents 351 total number annually fatal crashes per million takeoffs 1978 79 80 81 82 83 84 85 1978 79 80 81 82 83 84 85 sex ducts Charters and other Small carriers estimate Chicago Tribune graphic sources National transportation safety boart and of Federal aviation administration 4 Are charged in gooey protest Ambridge a. A four people including a minister were charged with littering and disorderly conduct after Mem Bers of a jobless advocacy group dumped Honey Popcorn and marshmallows outside a Mellon Bank office police said. Members of the network to save the Mon Ohio Valley spread the gooey mixture on the sidewalk of the hard hit Mill town of Ambridge near Pittsburgh police said. The Bank was closed for about 20 minutes be fore patrons were allowed in a Side door. A spokesman for Mellon declined com ment on the demonstration. The group blames Mellon and other Pittsburgh corporations for causing unemployment by investing in other areas. Mem Bers use confrontational tactics to Call at Tention to the plight of the jobless. The four included the Rev. John Gropp 36, pastor of Christ lutheran Church of Duquesne. Twa s Normal daily departures and 84 percent of Normal seating capacity Kem Nitz said. In another development the City Council in Kansas City decided Friday to continue a $300-a-Day lease of space in the municipal auditorium to Twa for training new flight attendants. In a letter delivered to City officials Fri Day Twa had threatened to sue if the City tried to break the lease. Some Council members had indicated thursday that they would like to accommodate labor officials request and get out of the lease which runs from feb. 14 to March 24. This is a knife in the Back James Walsh an attorney for the flight attendants said. Union members will picket the auditorium in protest. Twa has offered the attendants a con tract that cuts their pay 22 percent and requires them to work More hours. The attendants have agreed to a 15 percent Cut in base pay but not to changes in work rules already accepted by other Twa workers. In the stars and stripes 40 years ago today. March 17, 1946 the United states was reported to have assured both Iran and Turkey that it would stand with them against any foreign aggression that violated the principles of the . Charter. 30 years ago today. March 17, 1956 the French army sent troops into the streets of Algiers to enforce a curfew imposed after moslem re Bels unleashed terror raids in the City. Mean while the French Senate voted to give pre Mier Guy Mollet special Powers to Deal with the rebellion. 20 years ago today. March 17, 1966 the gemini 8 Astro nauts soared into orbit on Man s most difficult space venture and linked up with an Agena satellite after a 105,000-mile Chase space officials at Cape Kennedy announced. 10 years ago today. March 17, 1976 British prime minister Harold Wilson announced he will resign As soon As the labor party picks a new Leader. Wilson 60, cited age As the reason