For over thirty years, David F. Kelly has worked with medical practitioners, students, families, and the sick and dying to confront the difficult and often painful issues that concern medical treatment at the end of life. In this short and practical book, Kelly shares his vast experience, providing a rich resource for thinking about life's most painful decisions.

Kelly outlines eight major issues regarding end-of-life care as seen through the lens of the Catholic medical ethics tradition. He looks at the distinction between ordinary and extraordinary means; the difference between killing and allowing to die; criteria of patient competence; what to do in the case of incompetent patients; the meaning and use of advance directives; the morality of hydration and nutrition; physician-assisted suicide and euthanasia; and medical futility. Kelly's analysis is sprinkled with significant legal decisions and, throughout, elaborations on how the Catholic medical ethics tradition—as well as teachings of bishops and popes—understands each issue. He provides a helpful glossary to supplement his introduction to the terminology used by philosophical health care ethics. Included in Kelly's discussion is his lucid description of why the Catholic tradition supports the discontinuation of medical care in the Terry Schiavo case. He also explores John Paul II's controversial papal allocution concerning hydration and nutrition for unconscious patients, arguing that the Catholic tradition does not require feeding the permanently unconscious.

Medical Care at the End of Life addresses the major issues that inform this last stage of caregiving. It offers a critical guide to understanding the medical ethics and relevant legal cases needed for clear thinking when individuals are faced with those crucial decisions.

David F. Kelly is professor emeritus of theology and health care and was the founding director of the Health Care Ethics Center at Duquesne University. Among his books are Critical Care Ethics: Treatment Decisions in American Hospitals and Contemporary Catholic Health Care Ethics. He is coeditor of Three Patients: International Perspectives on Intensive Care at the End of Life.

Acknowledgments

Introduction

Abbreviations

Chapter 1. Ordinary and Extraordinary Treatment

Chapter 2. Killing and Allowing to Die

Chapter 3. Decisions by Competent Patients

Chapter 4. Decisions for Incompetent Patients

Chapter 5. Advance Directives

Chapter 6. Hydration and Nutrition

Chapter 7. Physician-Assisted Suicide and Euthanasia

Chapter 8. Medical Futility

Glossary

Cases Cited

References

Index