What are the implications of taking seriously Chaïm Perelman's proposition that “definitions are rhetorical”? Efforts to find Real Definitions are dysfunctional to the extent they direct argumentation toward pseudo “is” claims and away from explicit “ought” claims about how words are to be used. Addressing definitional disputes explicitly as propositions ofought rather thanis could put on the agenda the pragmatic concerns of definitional choice that might otherwise remain tacit.

This paper reports on a mail survey of Jewish nursing homes nationally regarding their compliance with the federal Patient Self-Determination Act that became effective in December, 1991. Data is presented about the extent to which institutions' religious affiliation has influenced their advance directive policies and the procedures they have adopted to implement those policies. A content analysis of written advance directive policies used in Jewish nursing homes is presented also.

Traditional medical ethics and law draw a sharp distinction between allowing a patient to die and helping her die. Withholding or withdrawing life sustaining treatment, such as by abating technological nutrition, hydration or respiration, will cause death as surely as a lethal injection. The former, however, is a constitutional right for a competent or once-competent patient, while the latter poses a risk of serious criminal or civil liability for the physician, even if the patient requests it.