Contrary to Fleetwood and Unger's claims [1], the New York State Task Force on Life and the Law does not propose that physicians receive special or automatic immunity for following the advice of an ethics committee. As part of a broad proposal covering surrogate decisions for patients without decision-making capacity who have not provided treatment directives [2], the Task Force has recommended legal protection for health care professionals who in good faith honor decisions made in accord with the proposal. Such decisions will rarely involve ethics committees, which play only a limited role in the proposed policy and have little if any decision-making authority. Under the proposal, responsibility for health care decisions rests with the patient's surrogate and attending physician. A physician who in good faith honors a surrogate's decision would equally receive legal protection, whether or not an ethics committee is involved.

The Task Force proposal calls for ethics committee participation in some cases of unresolved dispute and in special circumstances, such as those in which a physician judges that life-sustaining treatment should be foregone for an incapacitated patient who has no surrogate. Specific provisions to protect the rights of patients and others address the concerns raised by Fleetwood and Unger. For example, the proposal requires committees to notify all involved parties that a case is being considered, to inform them about the committee and its procedures, and to permit them to present their views to the committee, with the option of being accompanied by an advisor [2].

Fleetwood and Unger note important concerns and rightly emphasize that procedures for ethics committees should be formulated to advance patients' interests. The Task Force's proposal for surrogate decisions, including its specific provisions on ethics committees, addresses these concerns in promoting our shared goal.