Document Type

Response or Comment

Publication Date



Marshall Klavan headed the Obstetrics and Gynecology Department of the Crozer-Chester Medical Center. He deeply feared strokes, perhaps because his father had been savaged by one. In 1993, Dr. Klavan wrote an advance directive which said that (as a court later put it) "he 'absolutely did not want any extraordinary care measures utilized by health care providers.'" On April29, 1997, Dr. Klavan tried to kill himsel£ He left suicide notes and a note refusing resuscitation. The next morning, medical center employees found him unconscious and took him to the emergency room, where he was resuscitated. By May 2, Dr. Klavan had fallen into a persistent vegetative state. His family and his lawyer told the center about his notes and his advance directive. On May 4, the center "agreed to provide care in accordance with" the advance directive, but on May 5 Dr. Klavan's condition worsened and the center again resuscitated him. He "then suffered a stroke that rendered him mentally and physically incompetent."


Reprinted with the permission of the Hastings Center Report and Wiley-Blackwell.