Medical Care at the End of Life: A Catholic Perspective

Medical Care at the End of Life: A Catholic Perspective

Medical Care at the End of Life: A Catholic Perspective

Medical Care at the End of Life: A Catholic Perspective


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.


For the past thirty years I have written about medical ethics and taught the subject to physicians, nurses, social workers, hospital chaplains, undergraduates, and graduate students. During this time I have been active in American hospitals and nursing homes, helping patients and their families deal with the difficult and often painful issues regarding medical treatment at the end of life. As I have worked on hospital ethics committees, designed hospital and nursing home policy, and taken part in ethics consultations, I have also helped my own friends, colleagues, and family members work their way through these issues. In this book I write about what I have learned. My aim is to provide patients, their families, hospital chaplains, and the entire health care community with a useful resource for thinking about decisions that so many people, at some point in life, must face.

This, then, is a practical guidebook that describes in detail the American ethics and law about forgoing treatment. It draws on Roman Catholic medical ethics, since much of what has become American policy in the area was taken from Catholic sources, and it engages certain questions that are currently debated within Catholic medical ethics. But it is not intended only or even primarily for those interested in Catholic issues. It is a book about the ethics of end-of-life care in America.

Two recent events have focused attention, both within and without the field of Catholic bioethics, on this critical issue. In March 2004 Pope John Paul II delivered an allocution, also known as a . . .

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