The MacNeil/Lehrer NewsHour

Intro

JIM LEHRER: Good evening. The leading headlines today are these. A tentative settlement has been reached in the United Airlines strike. The House revoked the ban on military aid to the Nicaraguan guerrillas. Defense Secretary Weinberger said Navy spies should be shot, and two Middle East airliner hijackings ended without death or injury. Robert MacNeil is away tonight; Charlayne Hunter-Gault is in New York. Charlayne?

CHARLAYNE HUNTER-GAULT: The NewsHour tonight is made up of a summary of the news of the day, a focus section, a profile and a newsmaker interview. The first is a focus section on Karen Ann Quinlan and some of the troubling questions raised by both her life and death. On the occasion of Indian Prime Minister Rajiv Gandhi's visit to the United States, we have a documentary report on how he's tried to change the troubled country he inherited from his mother six months ago. And we have a newsmaker interview with U.S. attorney Rudolph Giuliani, a key player in the biggest credit card fraud case in U.S. history.News Summary

LEHRER: The pilots' four-week strike against United Airlines may soon be over. A tentative agreement was reached today by negotiators for the company and the pilots' union, the Airline Pilots Association. The settlement was announced by the National Mediation Board and was based on a proposal crafted by the board's chairwoman, Helen M. Witt. The deal must now be ratified by the union's full leadership, which could take, according to one spokesman, some days. Terms of the agreement were not announced, but the unresolved issues all had to do with back-to-work rights of various pilots and other employees. Charlayne?

HUNTER-GAULT: The Democratic-controlled House reversed itself today and handed President Reagan solid victories in votes on administration policy towards Nicaragua. By a 248-to-183 tally the House approved a plan to provide $27 million to the contras fighting the Nicaraguan government. The contra aid is restricted to non-lethal items such as uniforms and medical supplies. Just two months ago the Democratic majority of the House had rejected any aid to the contras. Another major win for the President came when the House voted down the Boland Amendment. Cokie Roberts of National Public Radio reports from Capitol Hill.

COKIE ROBERTS, National Public Radio: Four times in the last three years the House of Representatives has voted to prohibit any military assistance to the anti-government forces in Nicaragua. Today the House changed its mind. It was a significant victory for the Reagan administration, which has worked hard to eliminate the prohibition called the Boland Amendment. Since the last aid vote in the House, Democrats have been under considerable political pressure from the White House to go along with the President on Nicaragua, but the House Democratic leadership hoped to hold the troops in line on the ban against military assistance offered as an amendment to the administration-backed proposal.

Rep. DAVID OBEY, (D) Wisconsin: This proposal is very clearly nothing but a Trojan Horse that will allow the resumption of direct military activities through intelligence agencies after October 1st.

Rep. RICHARD CHENEY, (R) Wyoming: The administration and many of us on this side of the aisle interpret the practical effects of the Boland Amendment as being a killer amendment, a killer amendment in the sense that it specifically would require, we believe, the contras, the Nicaraguan democratic resistance, to lay down their arms, to give up their fight, to cease their struggle against the Communist government of Nicaragua in order to receive assistance.

Rep. JIM WRIGHT, (D) Texas: If you vote today to reject the Boland Amendment, you are absolutely, clearly voting to do away with the restraint that exists in the law today against the United States financing an invasion of that country.

Rep. TOMMY ROBINSON, (D) Arkansas: I made a big mistake. I let my leadership and the liberals in this Congress convince me that Daniel Ortega was going to do right. He didn't do right. They have a Neville Chamberlain mentality. But I've got the guts to stand up here today and tell you the President is right. Don't be deceived by the Boland Amendment. What do you think we're doing in Nicaragua? We're trying to thwart Communism.

ROBERTS: Congressman Robinson is one of 58 Democrats who switched sides and voted with the Republicans today. There was a good deal of political pressure put on those Democrats to go along with President Reagan in his efforts to fight the Marxist government in Nicaragua. There'll be other attempts to reinstate the ban on military assistance to the rebels but, given today's overwhelming vote, they seem unlikely to succeed. Jim?

LEHRER: Prime Minister Rajiv Gandhi of India met with President Reagan at the White House today. It was Gandhi's first trip to the United States since replacing his assassinated mother, Indira Gandhi, as prime minister six months ago. The tightest possible security prevailed around the White House and the immediate area of Washington. A group of Sikh extremists were arrested a few weeks ago for plotting to assassinate Gandhi while he was in the United States. Militant Sikh demonstrators were across the street from the White House at Lafayette Park this morning. President Reagan, in a welcoming statement, told Gandhi the U.S. supports his efforts to resist the Sikhs' pressure for a separate state. He and Gandhi also spoke of the two nations' shared democratic values, which they agreed are stronger than any differences.

Pres. RONALD REAGAN: Mr. Prime Minister, you'll find that we respect India's nonalignment and recognize the pivotal role your country plays in South Asia. We are supportive of your efforts and those of others in South Asia to overcome past animosities in seeking stability, security and cooperation in the region. Our countries have areas of disagreement, yet these are opportunities to prove our mutual good will by discussing our differences forthrightly. We do so with confidence because we're convinced that our fundamental areas of agreement far outweigh the differences of the moment.

RAJIV GANDHI, Prime Minister of India: Yes, there are differences, but rising above them are the beliefs we share in common, in the supremacy of freedom, in the necessity of equality, in the sovereignty of the people's will. It should be the task of all of us who hold responsibility for other people's lives to recognize what life and its continuous demand in this hate-filled, violence-prone world of ours. The inevitability of coexistence must propel us towards the imperative of cooperation.

LEHRER: Prime Minister Gandhi will be in the United States until Monday. His itinerary includes a speech to a joint session of Congress and a newsmaker interview with us Friday night. We will have a profile of him later on in this program.

And Defense Secretary Weinberger came down hard on the alleged Navy spies today. He said all four should be shot if convicted. He said the Pentagon was already studying ways of changing the military justice system to include the death penalty for peacetime espionage. Under current law, life imprisonment is the maximum sentence the four accused Navy spies could get upon conviction. The four are John Walker, Jr., his brother and son and close friend, all with Navy connections.

HUNTER-GAULT: In the Middle East today the news was about two hijackings, each related to the other. In Cyprus a lone hijacker held 156 passengers hostage for several hours, then agreed to let them go. He was permitted to board a plane bound for Jordan. And, in Beirut, Shiite Moslem hijackers liberated 66 passengers and crew after first threatening to start shooting them unless all Palestinian guerrillas left Beirut. Their deadline was 2:00 p.m. Beirut time. Keith Graves of the BBC has a report on both hijackings.

KEITH GRAVES, BBC [voice-over]: Just before their deadline was reached, the hijackers stopped negotiating with Beirut control tower and asked for a bus for the passengers. First off the aircraft were some of the hijackers, now known to be Shiite Muslims. Then the passengers, in a very orderly fashion, left the plane. Given that they'd spent 24 hours flying around the Mediterranean, constantly threatened with being killed and, at one point, close to being shot down by the Syrians, it was all very civilized as passengers and crew shook hands with their captors. It had not always been quite so gentlemanly. At one point during the morning, as fellow Shiite Muslim militiamen approached the aircraft, the hijackers had opened fire on them. But they seemed determined now to ensure there was no bloodshed as the passengers were driven away to safety.

But with everyone safely clear, one of the hijackers revealed that they were going to carry out their threat and blow up the aircraft. The aircraft was a write-off. The hijackers vanished into the safety of the Shiite Muslim area next to the airport, but at least no one had been hurt.

But for some of the passengers, their ordeal was not yet over. They caught a Middle East Airlines flight to Cyprus, and when that arrived there it was hijacked, this time by a Palestinian, in retaliation, he said, for the previous hijacking. The passengers all managed to escape, many having made a bizarre bit of history -- hijacked for the second time in two days.

LEHRER: In Rome, papal assassin Mehmet Ali Agca told the court his Bulgarian accomplices also plotted to kill Polish Solidarity leader Lech Walesa. He said the killing was to be done with a car bomb when Walesa visited the Pope in 1981, but it was called off when Italian police got wind of it. Today was the fifth day for the testimony of Agca in the trial of three Bulgarians and four Turks accused of plotting with him to kill Pope John Paul II.

In Brazil authorities said today handwriting analyses show similarities between the writing of the man who died in 1979 and that of Nazi Doctor Josef Mengele's application for the SS, Hitler's elite guard. Yesterday Mengele's son Rolf, a West German lawyer, said he was sure the dead man was his father. Today, both U.S. and Israeli officials said they would continue to search for Mengele, however, until the identity was known for certain.

HUNTER-GAULT: Relatives and friends mourned today at the death of Karen Ann Quinlan, the woman from Morris County, New Jersey, who lived in a coma for more than nine years after she was removed from a mechanical respirator. Karen Ann Quinlan's case was a landmark in the trend towards removing artificial life support systems from patients who are terminally ill and brain dead. With the permission of the New Jersey Supreme Court, she was separated from the machine that kept her breathing for more than a year after she fell into a coma because of irreparable brain damage. But she lived on for nine more years until last night, when she died at the age of 31. Her family priest, Monsignor Thomas Trapasso, was at the nursing home when she died. Today he said this.

Mgr. THOMAS TRAPASSO, Quinlan family priest: I grieved when I saw Karen die. She's gone. There's that sense. Now that a space of about 24 hours, the issue is again very much alive. Death with dignity, as the phrase goes. I think that was achieved in a very beautiful way with the family being present there. It was the way they had hoped it would be, that it would be quiet and with everyone there that was supposed to be there.

HUNTER-GAULT: Later in the program we'll have a discussion of the legal and moral legacies of the Karen Ann Quinlan case.

LEHRER: Finally in the news of this day, Attorney General Edwin Meese made a pitch for more money to combat drug traffic. He said at a news conference that $101.6 million more was needed to increase the number of regional drug task forces and to buy additional high-speed boats, airplanes and other equipment.

EDWIN MEESE, U.S. Attorney General: Congress has passed investment in the President's organized crime and drug enforcement initiative, and in the South Florida task force has paid strong dividends in terms of law enforcement achievements. Some 5,439 indictments and already over 2,000 convictions have been recorded since the 13 regional task forces went into operation. With these additional resources we will be able to shake the foundation of deeply entrenched and sophisticated drug empires. By bringing the number of task forces to 21, we can substantially increase the number of drug investigations and prosecutions. With more agents on the job we can pursue more leads, leads that take us to other parts of the globe. With the needed communications and investigative equipment we can stop drugs before they cross our borders.

LEHRER: The money requested by the attorney general will be shared by the Justice Department's cabinet drug war allies, the Treasury and Transportation departments. Life and Death Legacies

HUNTER-GAULT: We focus first tonight on the life and death of Karen Ann Quinlan, the young woman who became a symbol of one of the major issues of the 20th century, the right to die with dignity. She was only 21 years old in 1975 when she slipped into a coma caused by a combination of prescription drugs and alcohol. Ms. Quinlan died last night at a New Jersey nursing home without ever realizing that she had become a symbol and a household name. It was her adoptive parents, Joseph and Julia Quinlan, who went to court in 1975 to force her doctors to remove her from a respirator after she lost brain function and was said to have no prospect of recovery. In March 1976, the New Jersey Supereme Court handed down its landmark ruling sanctioning the removal of life support systems and touching off a nationwide debate over the so-called right to die. But even after the respirator was shut off, Karen Ann Quinlan continued to breath on her own, and year after year saw no change in her condition until last night.

With us tonight is Karen Ann's doctor, James Wolf, who treated her for the last six years. Dr. Wolf, tell us, what caused Karen Ann Quinlan's death finally after 10 long years?

JAMES WOLF: It was finally a combination of things. Ultimately respiratory failure coming about from the complications of a pneumonia she developed over the weekend.

HUNTER-GAULT: Was the pneumonia something that you treated and she didn't respond?

Dr. WOLF: No, there was no treatment planned, and there was no treatment given. During the years she had never received any specific treatment for any of the illnesses that she underwent.

HUNTER-GAULT: Why was that?

Dr. WOLF: That was the wishes of the family and consistent with my thinking on what should have been done for someone with that kind of brain condition.

HUNTER-GAULT: Were there other close calls that she had during this 10-year period that might have --

Dr. WOLF: She had a number of occasions where she was in respiratory distress but did pull through those.

HUNTER-GAULT: Was that pneumonia also, or just breathing problems?

Dr. WOLF: I presumed pneumonia. I obviously didn't -- that was the clinical diagnosis that I made. We didn't undertake any specific tests or anything special to confirm, you know, what those episodes were. She was basically treated with nursing care and supportive care.

HUNTER-GAULT: During those periods where she was apparently having more than unusual -- I mean, realizing that she was in an unusual -- extended unusual episode, was there any indication that she was in distress or aware in any way of going through a more terrible ordeal than what she normally was being exposed to?

Dr. WOLF: No, there was certainly no awareness or no evident awareness that I could glean that she was in any, you know, distress and that she was suffering in any way.

HUNTER-GAULT: At the time of the court case it was thought that she would probably die immediately as soon as she was taken off the respirator, and she didn't, as we know. What is the reason for that, do you think?

Dr. WOLF: Well, there was, I believe, a difference of opinion, although I was not involved in the case at that time. There were neurologists who advised the family that she may indeed live a prolonged period of time. So the medical opinion at that time was not uniform as to what the prognosis was.

HUNTER-GAULT: Right. Having lived the length of time that she had, and 10 years having elapsed in which presumably the medical community may know a little bit more about this, is this unusual or --

Dr. WOLF: Her condition was not unusual medically. It's a condition that many people have had and continue to have. And although the medical literature would indicate that the average survival is three or four years, there are certainly people who have survived even longer than 10 in her condition.

HUNTER-GAULT: It was said -- I heard this on the news today and read in the paper that her parents visited her every day. Did they attempt to communicate with her, and was there any indication at all that she heard any of that or responded to it in any way?

Dr. WOLF: They did talk with her, as did the nursing staff, and on occasion I myself spoke with her. But, no, there was never any indication that there was any response.

HUNTER-GAULT: How are her parents? They've requested, you know, that they be left alone, as is understandable, but what's your sense of how they are taking this?

Dr. WOLF: Well, I think, you know, they're reacting as most people would, a sense of grief, a loss, but also --

HUNTER-GAULT: Second time around grief.

Dr. WOLF: Yes, a long-delayed grief, in a way, but also with a sense of relief, I believe.

HUNTER-GAULT: You've spent a lot of time with her. This may not be an appropriate question to ask a medical doctor, but how are you taking it?

Dr. WOLF: I am taking it fine, thank you.

HUNTER-GAULT: Was it a difficult period of service for a patient like this?

Dr. WOLF: It certainly wasn't difficult because most of the decisions, you know, had been arrived at quite amicably, and so we knew where we were going, and I was really an observer during those years. So it wasn't really difficult for me. And emotionally I think I was simply waiting for the end, like the family was.

HUNTER-GAULT: I see. Well, we'll come back. Jim?

LEHRER: We move the discussion now to some of the issues that swirled around the Karen Ann Quinlan case for 10 years. A group that followed them closely is the Society for the Right to Die. The society's executive director is Alice Mehling. Ms. Mehling, how important was the Karen Ann Quinlan case to your cause?

ALICE MEHLING: It was a landmark decision around the whole issue of the right to die -- not for our cause, for the cause of people who are concerned about this issue. It was the first. I think its importance was that it reached the constitutional right-of-privacy question, but also it addressed the issue of decision-making. Who will make decisions and how will they be made? And I think that the New Jersey Supreme Court, because Karen could not make decisions for herself, quite appropriately said that the decision should be made by her family. And I think that that was an appropriate decision.

LEHRER: That was the first time a court had said that, is that correct?

Ms. MEHLING: This is the first right to die case in this country, was the Quinlan case. There have been some 20 that have reached the highest courts in 11 states since then, but this was the first. It was a landmark decision.

LEHRER: And the others since the Karen Ann Quinlan case, have they pretty much affirmed the same position?

Ms. MEHLING: Yes. All of the decisions except for one, the Storer case in New York, have upheld that there is a right to be allowed to die, that the preservation of life using technological means when a patient has been confirmed to be terminal is not required.

LEHRER: All right, now how far, generally, does the right to die go? What does that mean specifically?

Ms. MEHLING: Well, it really has to do with the right to be allowed to die when a person's condition is hopeless, and when we speak of a right we're really talking about upholding the right of people as to what they want for themselves at the end of life. In other words, their right to control decision-making. And this is very difficult because people at the end of life are not frequently competent and able to control decision-making. So therefore how do they protect that right? How is it possible for them to establish and protect that right and control that decision-making? And that's a very knotty question which is answered by means of -- certain means, one being a living will, where a person sets out in advance what their directions are; another means is by the appointment of a proxy, use of durable power of attorney, whereby you appoint someone that you would trust.

LEHRER: In other words, you'd do that, though, before you're ill and before you're near death.

Ms. MEHLING: Oh, indeed, you do that in advance because you can reach the point where you may be incompetent and unable to direct this decision-making. It's very difficult for a dying patient to uphold their rights and to direct what should be done.

LEHRER: All of these efforts, then, have most of them come since the Karen Ann Quinlan decision?

Ms. MEHLING: Yes, the first living-will law, so called, the California Natural Death Act, was enacted in 1976, a few months after the Supreme Court decision in the Quinlan case, and there have been since that time 34 living-will laws enacted, 12 of them this year, and a 13th is on the desk of the governor of Connecticut.

LEHRER: From your perspective, how much more needs to be done in this area?

Ms. MEHLING: Well, there's a great deal of clarification of issues. It's not a simple matter. And what we see, really, is this whole patients' rights movement that has really surged in these years since the Karen Quinlan decision, and people must understand their rights and know how to exercise them. And that's not always very easy. Furthermore, even when you have a court decision, as there was in the state of Ohio, where a competent person requested -- where a case in which the court had upheld the turning off of a respirator, 76 physicians were approached before one would agree to do it, even though the patient was actually dying.

LEHRER: Okay, well, thank you. Charlayne?

HUNTER-GAULT: More than a few people are uncomfortable with the direction that the right to die movement has taken lately. One of them is Alan Weisbard, professor of law at Benjamin Cardozo School of Law in New York. He was also a member of the recently disbanded President's Commission on Medical Ethics.

Dr. Weisbard, do you think overall that the Karen Ann Quinlan case was positive or negative?

ALAN WEISBARD: I agree that the case marked a landmark in the development of American law, and I think it set in motion forces for good. I think we had come to a state that some have called a technological imperative, where many physicians felt that with the new power they had through medical technology to extend life, that if they could do it they must do it. And I think in that process we lost sight of the interests and wishes of patients. So I applaud the Quinlan case and other developments in the law for establishing a clear legal right of competent adults to decide to decline medical treatment. The question for me now is whether, once that pendulum has begun to swing, we're not in danger of it's swinging a bit too far.

HUNTER-GAULT: All right, what specifically bothers you?

Dr. WEISBARD: Well, in particular, two things. I think we are perhaps passing through a period when, primarily for reasons of economics, we may move from the so-called right to die to a duty to die. It's not an accident, I think, that many of the patients who have been involved as incompetent persons in these decisions have been life-long residents of mental institutions and senile elderly persons in nursing homes. I am very concerned that as we become more and more conscious of economic pressures, that we will move more quickly toward other people deciding -- the government, courts or others -- that it is best that persons who are vulnerable and weak would be better off dead because in part we're not willing to spend the money to provide them with a decent quality of life.

HUNTER-GAULT: So you're not objecting to a person, the kind of people Ms. Mehling has described, making decisions about their rights, but the other institutions outside of the family interceding, intervening?

Dr. WEISBARD: Well, of course, we also know that family dynamics can be very complicated as well, and there are issues of inheritance. There certainly are issues of the tremendous emotional and financial burdens that families live with when a family member has a prolonged illness. So I think even there it's sometimes a complicated question, and I'm not always sure it's a good thing to have a deep exploration in a court or elsewhere of all of the motives of family at a time that they're going through such a difficult experience.

HUNTER-GAULT: So what options would you see?

Dr. WEISBARD: Well, I would agree with Alice that, first, insofar as competent patients are involved, that they should have this right to decline treatment. Second, I applaud the trend toward durable powers of attorney and to some degree toward living wills and, more generally, it doesn't have to be so formal. Just the fact that doctors and patients are beginning to talk to one another about death and the wishes of the patients, I think, will have enormous impact. My concern is with those patients who have not given an indication of their wishes and with the plausibility of other people making decisions that they would simply be better off dead.

HUNTER-GAULT: Do you think the courts should be involved at all in setting guidelines?

Dr. WEISBARD: Well, there's been an enormous outcry for clear guidelines. What I'm concerned about is that any guidelines that are truly clear are likely to be wrong. I think these decisions are agonizing ones; I think they should stay agonizing ones. I don't think we should be moving toward a set of cookbook recipes for the discontinuation of life-continuing treatment.

HUNTER-GAULT: Do you think that's what we have now?

Dr. WEISBARD: I think we are beginning to move in that direction, and I think if there is not increased concern with these issues that that is a real danger. And we're starting to see that on yet another frontier, as increasingly people are discussing the termination of food and water for patients in these conditions --

HUNTER-GAULT: Which has also been upheld by the courts.

Dr. WEISBARD: By a couple of courts, that's right.

HUNTER-GAULT: All right, we'll come back. Jim?

LEHRER: Ms. Mehling, is that what's happening, we're moving toward a cookbook guideline rundown on who dies and why?

Ms. MEHLING: I don't see that happening at all. I really see what has happened is that the courts have called upon the legislatures to provide general guidelines for the protection of patients' rights and to protect physicians who act in accordance with what the patient wants as stated in an advance living will. I see thousands of people writing to us requesting such documents because they want to protect their rights. I agree with Alan that it would be horrendous if the government or any outside group of any kind, whether it be -- and I take this as far as a hospital making decisions for people. I think people should make decisions for themselves. I don't think there should be interference with that process.

LEHRER: But what about his concern about members of the family? There could be some problems there.

Ms. MEHLING: There have been a number of states where they have set forth that witnesses cannot stand to inherit or be related. This is always a possibility that is put forth. What we see is, over and over again with people who call our office, loving family members who are concerned about the father, a mother, a husband, a wife, who are being prolonged and everyone is suffering. The patient is suffering, the family is suffering; everyone is suffering.

LEHRER: Mr. Weisbard?

Dr. WEISBARD: I'd like to point out how broad our agreement is. Alice and I, I think, are in complete agreement that the desirable outcome is for doctors, patients and families to discuss these issues in advance and for doctors to then respect the decisions that are made. I think there is no question that that would be a preferable situation. Our area of disagreement is limited to those patients who have never given an indication of what their own wishes would be, and at that point I think my concern about abuse of the system, and in particular the increasing pressure of economics, is something that has to be weighed against the other concern, which is having the suffering of people prolonged when they would not want that.

LEHRER: Let me bring Dr. Wolfinto this. Dr. Wolf, were you at all concerned as a physician that the decision not to treat Karen Ann Quinlan came not from her but came from her parents?

Dr. WOLF: Well, it did come from her parents, technically speaking.

LEHRER: I mean, it came from her parents, but it did not come from Karen Ann Quinlan.

Dr. WOLF: But they had gone through an agonizing court experience to, you know, obtain the right to speak on her behalf. So I was comfortable with that decision once it had been made.

LEHRER: Well, let me go back to you, Ms. Mehling, on the other point that Mr. Weisbard mentioned, [Which] was the denial of food and water. Is that part of your belief that that should be also denied or withdrawn if a patient wants it, or if a doctor, family, etc., decides?

Ms. MEHLING: I believe that, as far as denial, I think it can be withdrawn or withheld; just as artificial air can be withheld, so can artificial food when the condition is hopeless. There is no reason that food has to be, or liquid nutrient has to be pumped into a dying patient or a comatose patient, any more than air needs to be pumped in by a respirator. This has been equated. It's a very emotional issue because we think that the patients are going to be hungry. This is not true. What is sad is to see old people who have executed living wills in coma, comatose, permanently unconscious for two years, three years, four years, lying in a bed being maintained because of artificial feeding. And if people don't want that, they shouldn't have to have it. If they want it, they should have it. I think that the key thing is, what do people want for themselves, and then, is it right for others to stand in their way in terms of withholding or withdrawing such procedures?

LEHRER: What is your position on that, Mr. Weisbard?

Dr. WEISBARD: Two points. First, I largely agree with Alice about competent adults. What I see happening more and more is discussion in nursing homes with populations of large numbers of what one journal referred to as "pleasantly senile" individuals from whom food and water are being removed, and often without any evidence that that's what they'd like. I'd also like to point to a second piece of this puzzle, which is the effect of these practices on physicians and on societal understanding of the role that they should play. We all understand that terminating food and water to individuals will result, and result rather quickly, in their deaths. I nd it very difficult, and I've thought through this with great agony, to distinguish that from, for example, the giving of a lethal injection. I think that the arguments that are being made, particularly with respect to noncompetent individuals, that would justify withholding of food and water will also turn out to justify active euthanasia, and that conclusion, I think, is a very troubling one in this society.

LEHRER: Dr. Wolf, what's your position on food and water?

Dr. WOLF: Well, I have my personal feelings about it, and I think in general I consider food and water to be ordinary care and really, in most circumstances that I can think of and have experienced within my practice, should be continued.

LEHRER: No matter what?

Dr. WOLF: In most circumstances.

LEHRER: Well, now, Karen Ann Quinlan, she continued to get food and water.

Dr. WOLF: That's correct.

LEHRER: And if somebody had asked you, if the parents had asked you to deny her food and water, would you have done it?

Dr. WOLF: That's a question I would have had to agonize over, to be sure. If I found that in that circumstance I was not able to come to that decision, then I would have advised the family of that and sought to find a physician, perhaps, to take over her care who would comply with their wishes.

LEHRER: Ms. Mehling, what about Mr. Weisbard's point that there is a short step from denying food and water to euthanasia?

Ms. MEHLING: I don't equate the two at all. I equate artificial feeding with other artificial procedures. Karen Quinlan was given food and water, true, but given it artificially. An invasive procedure was needed in order to insert a tube. It was an artificial means. Fifty years ago people didn't have to be subjected to that, and we didn't talk about that it was euthanasia. My own mother died of cancer and didn't eat for at least two months, at least, and there was no attempt made to feed her artificially. I don't understand why artificial feeding is a requirement in terms of procedures for a patient whose condition is hopeless.

LEHRER: Well, on that one I believe you're outvoted, and we'll leave it there. Ms. Mehling, Mr. Weisbard and Dr. Wolf, thank you all three for being with us. Charlayne?

HUNTER-GAULT: Still ahead on the NewsHour, a special documentary report on how Indian Prime Minister Rajiv Gandhi has led his troubled country since he took charge six months ago, and a newsmaker interview with U.S. Attorney Rudolph Giuliani, a key player in uncovering the biggest credit card fraud in U.S. history. Profile: Rajiv Gandhi

HUNTER-GAULT: We turn now for a closer look at the man who shared the spotlight with President Reagan today, Indian Prime Minister Rajiv Gandhi. Over the past six months American filmmaker Anne Drew has been closely following the new prime minister in preparation for a full one-hour documentary scheduled for this fall. Using her material, we have prepared a profile of Rajiv Gandhi as he attempts to put his stamp on a country already indelibly marked by his mother Indira and his grandfather Nehru.

[voice-over] When Rajiv Gandhi came to power six months ago, it was as the untested son of a strong woman who had ruled India off and on for the past 18 years. But from the beginning the 40-year-old former airline pilot has pursued his own agenda, bolstered by his call for an early election that gave him plurality greater than any ever won by his mother Indira or his grandfather Nehru. That overwhelming mandate has given Gandhi the courage to change things and the confidence to act decisively. There were many who had serious doubts at first, including the prominent Sikh historian and political commentator Khuswant Singh.

KHUSWANT SINGH, Sikh historian: I had my initial reservations because I felt that his becoming prime minister after his mother, and his mother becoming prime minister after her father was introducing a kind of dynasty to this country. But then when that person is elected democratically you have to accept it, whether it is a dynastic democracy, or whatever you may like to call it. I also had my doubts about his ability. You can't get a man out from an airlines company -- he was a pilot -- and make him prime minister and expect him to run a country with 750 million people.

HUNTER-GAULT [voice-over]: His style is generally informal. He works long hours, especially on one of his major priorities, making government work faster and more efficiently. His first target for reform was the country's 15-member cabinet. He replaced tarnished favorites of his mother's administration with younger candidates whom he regarded as better qualified. He fought corruption in government at both the national and local level with a campaign to stop the common practice of buying and selling votes. That campaign resulted in a successful bill to prevent party switching, and not only handed Gandhi his first parliamentary victory but signaled a new moral tone for his administration. The new prime minister also launched new economic initiatives, emphasizing long-term planning, greater freedom for private enterprise and promoting joint ventures with high-tech industries in the West, all departures from Mrs. Gandhi's regime.

The son had also departed from his mother's practice of personally trying to make nearly all government decisions of major consequence. Rajiv Gandhi has insisted on delegating authority to his ministers, while stressing that he would also hold them accountable. Gandhi has also been willing to make decisions by which he is judged.

GIRILAL JAIN, Times of India: So I can't recommend those actions of his which I've opposed as editor of the Times of India. But I must confess that it is difficult to cite a single instance where he has made a positively bad move.

Mr. SINGH: But he has shown remarkable powers of adaptation and changing from a simple pilot to prime minister. I am pleasantly surprised. He has an enormous presence. He is now quite decisive, he speaks extremely well, and so far has shown a lot of progressive ideas.

HUNTER-GAULT [voice-over]: Rajiv Gandhi has so far achieved a balance between the progressive and the traditional in Indian politics. He is at home talking with villagers about their problems in the ancient Indian custom of dharshan, in which they bring their troubles to him personally several times a week. He also seems at ease talking personally with world leaders. His first exposure as an international leader of world status was when he played host to a gathering of prime ministers and presidents from nations, including Greece, who called for an end to the nuclear arms race. As a new leader, Gandhi has been tested with an unusual array of problems: the Union Carbide plant tragedy at Bhopal that left almost 2,000 of his citizens dead; the uncovering of a spy ring in the prime minister's office; riots between castes; and guerrilla warfare in neighboring Sri Lanka. On his own border he has watched the army of an adversary grow stronger.

RAJIV GANDHI: We have had now, what, three aggressions by Pakistan on India, and we find it very worrying, just like we find the weapons sales worrying. The weapons that they're getting are capable of carrying nuclear weapons; the aircraft that they're getting are capable of carrying nuclear weapons. Most of the weapons they're getting are not such that can be used in the mountains of Afghanistan. They're such that are used in the plains, which means India. So this all worries us. And what also worries us about the nuclear program is that the U.S. has some laws -- you have, I believe, something called the Symington Amendment and Pakistan has been made the only exception to that amendment. Which makes us worry a little bit.

HUNTER-GAULT [voice-over]: Gandhi may have caused the United States to worry some about where he stands with America's main adversary, the Soviet Union. While Gandhi's foreign policy rests on a pillar of nonalignment, he reaffirmed friendly ties to the Soviet Union in this recent visit with Soviet leader Gorbachev in Moscow and criticized some U.S. policies, specifically Star Wars and Nicaragua. But he hopes to build on improved U.S. relations also. One goal of his U.S. visit is to complete an agreement for the transfer of high technology from the U.S. to India. But at the moment Gandhi's most serious problem has nothing to do with superpower rivalries. It is an internal matter involving relations with the Punjab state. The Sikhs, the powerful religious minority, have demanded more autonomy, and Sikh terrorists in India and in a worldwide network have threatened more violence of the kind that resulted in the assassination of Indira Gandhi. At conferences of Gandhi's ruling Congress I party, the young prime minister urges Punjab development and pleads for unity and harmony with the Sikh community. But there is little indication that his pleas are having much effect on Sikh extremists. On May 10, 1985, Sikh terrorists struck in cities across northern India. Bombs hidden in transistor radios blasted people in the streets and on buses, killing 83 and wounding 150. It is widely believed that this attack on innocent bystanders was an attempt by the terrorists to provoke a backlash against all Sikhs and force further separation from India. Recognizing this ploy, Gandhi has intensified his pressure on the Sikh leadership.

Prime Min. GANDHI: We really have to make the Sikhs, the Sikh leadership, come out more forcefully against the extremists. And we have seen this during the last few days after these ghastly bombings in Delhi, that many Sikh leaders have come out openly.

HUNTER-GAULT [voice-over]: A Sikh moderate who rejects the separatist movement is Lieutenant General J.S. Aurora, a retired army war hero.

Lt. Gen. J.S. AURORA, Indian Army (Ret.): This challenge is to the fabric of the society, of the country itself. So it is a big challenge, and it is not a very simple one to handle like that. So he has my sympathies. But he can only handle it if he has a statesman approach as opposed to a political approach, and he has to stand firm.

HUNTER-GAULT [voice-over]: In recent months there have been reports of Sikh extremists using temples as sanctuaries to harbor terrorists and weapons. And now Rajiv Gandhi is confronted with the same decision that led to his mother's death -- whether his government troops will invade the holy places.

Prime Min. GANDHI: If we feel there are criminals in any religious place we'll send troops in, whether it's a Sikh temple or a Hindu temple or a Muslim mosque, or whatever. They can't hide criminals and weapons in religious places. It won't be allowed.

HUNTER-GAULT [voice-over]: That threat meets counterthreat. Sikh extremists have vowed revenge. An alleged assassination scheme was even uncovered in the United States by the FBI.

Prime Min. GANDHI: Well, I read it in the papers this morning, and it's good that they have caught them.

HUNTER-GAULT [voice-over]: If danger haunts Rajiv Gandhi, he seems not to let it show. It is for others to worry about.

Mr. JAIN: If Rajiv Gandhi cannot make it, it will be difficult for us to find someone who can make it, because it will be very difficult for us to produce a consensus or an agreement on any other person. So, in a sense, our destiny as a country is passing through his fingers. He holds them in the palm of his hands.

Prime Min. GANDHI: India will hold together, Nehru-Gandhi family or not. India is much bigger, much older, and it will go on forever.

HUNTER-GAULT: Rajiv Gandhi will be a guest on the NewsHour Friday, when we'll have a chance to talk with him further about Indian-American relations. Plastic Fraud

LEHRER: A major credit card forgery ring has been cracked by federal authorities. It is the subject of our next focus segment, to be conducted by Judy Woodruff. Judy?

JUDY WOODRUFF: Jim, with the arrest this week of 17 people and the seizure of 20,000 phony credit cards, prosecutors said today it is the biggest credit card fraud arrest ever in the United States. Those arrested were allegedly part of two separate counterfeiting groups operating independently in and around New York City. Besides the 20,000 Visa and Mastercards seized, agents also found enough material to make 80,000 more. A spokesman for Visa said the two operations represented more than half of all the company's operating losses throughout the world. Here to give us more details on the cases is a federal prosecutor who is deeply involved. He is Rudolph Giuliani, United States attorney for the Southern District of New York. Mr. Giuliani, first of all, how were the two rings discovered? What did it take to crack them?

Mr. GIULIANI: It actually began as a street-level investigation, kind of a classical case of working up from the very, very lowest rung on the ladder. New York City Police Department officers made purchases of counterfeit credit cards about a year ago, a little over a year ago, from people who were at a very, very low level. They then began working in coordination with the Secret Service and they began making purchases further up the line. They put in undercover agents; they started buying credit cards. That led to probable cause for electronic surveillance -- electronic surveillance carried out by the state Organized Crime Task Force and by the federal authorities -- as well as physical surveillance. It was an investigation that kept moving up the ladder to the point that it came at the beginning of this week when we were able to execute search warrants on about eight different locations and find a substantial amount of both the credit cards and the implementation.

WOODRUFF: Did they know in the beginning that they had two rings on their hands?

Mr. GIULIANI: No. At the beginning, actually, it looked like purchases from people basically on the street. It was something that built up from one level to the other level to the other level -- very, very much like the way a major drug case is made from the bottom up.

WOODRUFF: How were the rings operated? I mean, how exactly -- what were they doing? They were obviously making phony credit cards, but then how were they making money off them?

Mr. GIULIANI: Well, they were making phony credit cards in very, very large numbers. The level that we're talking about here allegedly was involved in millions and millions of dollars in phony credit cards. What they were essentially doing was selling to other distributors. In other words, they would not be selling to anyone on the street. They might be selling 1,000, 2,000, 5,000 credit cards to a particular distributor; that distributor would then do several things with these phony credit cards. He might sell it to individuals, and the undercover purchases ranged between $70 and $200 for a particular phony credit card, or a distributor might go around to a number of banks and use the phony credit cards in order to make cash withdrawals from a bank. So let's say you bought a credit card for $100. You might, in one month, be able to withdraw five, 10, 15, 20 thousand dollars in cash using that credit card as well as charging up a great deal of property before you discarded that credit card and then moved on to another. And in each case they were using actual credit card numbers. In other words, they would also get numbers of actual active credit cards. So they had about a one-month period in which they could charge items to that particular credit card number.

WOODRUFF: How do they get those numbers?

Mr. GIULIANI: The numbers were gotten in a number -- in several different ways. One way that is outlined in the complaint and that was uncovered during the course of the investigation was to get checks from restaurants, checks that actually were used for payment, and to obtain those checks, and, in the case of this one particular restaurant, Angelo's Restaurant on Mulberry Street, they superimposed the card, they embossed the card on the actual check itself. A number of these checks were found in the possession of the defendants, and they were using -- allegedly using those numbers and then having those numbers placed on the counterfeit credit cards.

WOODRUFF: Some sources who are close to the investigation told us today that the people who are arrested are connected with two Mafia families, the Bonanno family, the Luchesi family. Can you confirm that?

Mr. GIULIANI: I can't confirm that. That's not alleged in the complaint, so it's not part of the public documents. We worked very, very closely in this case, and a large amount of the credit for it goes to Ron Goldstock, who is the deputy attorney general in New York state that's in charge of the Organized Crime Task Force, and their jurisdiction requires that they be involved in cases that involve organized crime, and Mr. Goldstock made that clear yesterday. So I can at least repeat that part of it.

WOODRUFF: So we can draw our own conclusions.

Mr. GIULIANI: That's right.

WOODRUFF: How deep do the arrests go? I mean, has everybody been arrested so far who's involved? How much more is there yet to --

Mr. GIULIANI: Well, this is a continuing investigation. The Secret Service has been conducting this investigation for a year now along with the New York City Police Department, and the arrests are very, very substantial. And they believe that they've made very substantial inroads with these arrests, but it is by no means over with. There is still a continung area for this investigation and others like it.

WOODRUFF: How much more is out there still, or how many more?

Mr. GIULIANI: Well, the Secret Service estimates that this group was responsible for about $550 million in losses. The overall estimated losses are about a billion dollars. So the estimate that these two groups were responsible for about half seems like a pretty sound one. Congress last year passed a new statute that gives us additional penalties and a whole group of areas now that we can prosecute in federal court involving credit card fraud, and we're using that new statute in these cases.

WOODRUFF: So how much of a dent, then, would you say this makes in overall credit fraud?

Mr. GIULIANI: I think this makes a very substantial dent. I can't give you an estimate. I think the credit card companies and the Secret Service have probably more expertise in this area. They claim that we're talking about half the amount of fraud in this given year. So even if you give or take a little bit on that, you're talking about a very substantial inroad here, and the Secret Service gets great credit for it.

WOODRUFF: I read that credit card fraud is on the increase. Why is that? Is it because of the ease with which these sort of operations can get going?

Mr. GIULIANI: Absolutely. It is the ability to counterfeit on a major level and then the ability to extract large amounts of cash in a relatively short period of time. This whole area of credit card fraud is estimated to be one of the larger revenue producers for organized crime, which is something that's pretty new. I mean, this is something that is the product of the last couple of years.

WOODRUFF: Just one last thing. Is there any word of advice you would give to the consumer on how to protect himself or herself from this sort of thing, or is it the credit card companies that are really having to --

Mr. GIULIANI: It's both. From the point of view of the consumer you've obviously got to be very careful about leaving behind any record of your credit card number. I think it's even wise to not only destroy the carbons but to talk to a restaurant about not keeping your number in a situation where it can easily be found by other people. Credit card companies have to put a lot of emphasis on creating credit cards that are not able to be duplicated. The American Express card, for example, is more difficult to duplicate, and you don't find as much use of it in a counterfeit situation as some of the others. And that's something that they're going to have to be very careful about. It's costing them a lot of money, and in the long run it's costing the consumer a lot of money because the costs are largely passed along.

WOODRUFF: Rudolph Giuliani, thank you for being with us.

Mr. GIULIANI: Thank you very much.

WOODRUFF: Jim?

LEHRER: Again, the major stories of this Wednesday. A tentative settlement has been reached in the four-week pilot strike against United Airlines. The House voted to scrub the Boland Amendment, which bars military aid to antigovernment forces in Nicaragua. Defense Secretary Weinberger said if left to him the four accused Navy spies would be shot upon conviction. And two separate Middle East airliner hijackings ended with nobody being hurt. Good night, Charlayne.

HUNTER-GAULT: Good night, Jim. That's our NewsHour for tonight. We'll be back tomorrow night. I'm Charlayne Hunter-Gault. Good night.