ERCC1-Specific Immunostaining in Non–Small-Cell Lung Cancer

The Author Replies: I agree with Fine that "futility cases" -situations in which patients or family members demand treatments that seem unreasonable to the clinicians involved -are an important and difficult problem.I also agree that the Texas legislation has been effective in facilitating the resolution of these cases in a very efficient manner.We disagree, however, over the question of whether this approach can withstand ethical scrutiny and whether it is the best way of handling these challenging cases.Although it is true that the demands of some families are motivated by psychopathology or magical thinking, in some cases the dispute arises from a genuine disagreement about fundamental values.The problem with the Texas legislation is that it empowers the hospital ethics committee -mostly hospital employees -to adjudicate between the values of their fellow clinicians and