SIR,-Dr Phillips questions (April 17, p 1008) the value of twin studies in estimating the genetic component in the most common diseases of adult life. He points out that the intrauterine environment of twins, monozygous as well as dizygous, may be different and that this distinction may account for later differences in disease prevalence between co-twins. Thus, a greater concordance between mon...

Technology has provided means to sustain life and provide care regardless of whether the treatment is appropriate and compassionate given the condition of the patient. This study presents two case histories, compiled from historical patient charts, staff notes and observations, that illustrate the variety of ethical issues involved and the role culture plays in the decision making process relat...