Ethics at the End of Life

by Baergen, Ralph

• ISBN13: 9780534558451
• ISBN10: 0534558453
• Edition: 1st
• Format: Paperback
• Copyright: 2000-09-27
• Publisher: Wadsworth Publishing

Summary

This anthology deftly introduces students to the massive medical ethics literature on end-of-life issues, such as refusal of treatment, surrogate decision making, resuscitation policies, assisted suicide, and euthanasia. Although end-of-life issues are central, this text could be easily used as the basis for a much broader course in medical ethics. Each section's topic is introduced in an introductory essay that presents the central concepts, concerns, arguments, and positions. The selections that follow include the most influential work in each area, as well as ground-breaking newer essays. Essays have all been chosen for their accessibility to students and are augmented by the inclusion of a glossary of philosophical and medical terms. The discussions in each section are sensitive both to the clinical realities and the philosophical subtleties of each issue.

Table of Contents

Section 1: Ethics at the End of Life
Troubling Questions	1	(3)
An Overview of the Issues	4	(1)
Approaches to Addressing Ethical Issues	4	(19)
Suggestions for Further Reading	23	(2)
Section 2: Refusing Life-Sustaining Treatment
Introduction	25	(4)
``Depression, Competence, and the Right to Refuse Lifesaving Medical Treatment,''	29	(11)
Mark D. Sullivan
Stuart J. Younger
``Continued Treatment of the Fatally Ill for the Benefit of Others,''	40	(6)
Mark Yarborough
``What Do Apple Pie and Motherhood Have to Do with Feeding Tubes and Caring for the Patient?'' Jacquelyn Slomka	46	(9)
Discussion Questions	55	(1)
Suggestions for Further Reading	56	(3)
Section 3: Surrogate Decision Making
Introduction	59	(9)
``The Problem of Proxies with Interests of Their Own: Toward a Better Theory of Proxy Decisions,''	68	(10)
John Hardwig
``Decision Making in the Incompetent Elderly: `The Daughter from California Syndrome,''	78	(4)
David W. Molloy
Roger M. Clarnette
E. Ann Braun
Martin R. Eisemann
B. Sneiderman
``Taking Families Seriously,''	82	(11)
James Lindemann Nelson
Sample Statement of Patient's Preferences	93	(1)
Durable Power of Attorney	94	(3)
Discussion Questions	97	(1)
Suggestions for Further Reading	97	(4)
Section 4: Futility and Fighting Death
Introduction	101	(7)
``Futility in Practice,''	108	(6)
Lawrence J. Schneiderman
Nancy S. Jecker
``Medical Futility and Care of Dying Patients,''	114	(8)
Nancy S. Jecker
``Futile Care: Physicians Should Not Be Allowed to Refuse to Treat,''	122	(7)
Robert M. Veatch
Carol mason Spicer
Discussion Questions	129	(2)
Suggestions for Further Reading	131	(2)
Section 5: Resuscitating the Dying Patient
Introduction	133	(5)
``Emergency Department Resuscitation Techniques,''	138	(4)
Bryan Young
``Resuscitation of Patients with Metastatic Cancer: Is Transient Benefit Still Futile?''	142	(9)
Kathy Faber-Langendoen
``Must Consent Always Be Obtained for a Do-Not-Resuscitate Order?''	151	(6)
Rita T. Layson
Terrance McConnell
Discussion Questions	157	(1)
Suggestions for Further Reading	157	(4)
Section 6: Assisted Suicide
Introduction	161	(3)
``Death and Dignity: A Case of Individualized Decision Making,''	164	(4)
Timothy E. Quill
``Giving Death a Hand: When the Dying and the Doctor Stand in a Special Relationship,''	168	(7)
Nancy S. Jecker
``The Reasons So Many People Support Physician-Assisted Suicide--And Why These Reasons Are Not Convincing,''	175	(12)
Yale Kamisar
Discussion Questions	187	(1)
Suggestions for Further Reading	188	(3)
Section 7: Euthanasia
Introduction	191	(6)
``The Doctrine of Double Effect and the Problem of Euthanasia,''	197	(8)
Whitley Kaufman
``Euthanasia: Historical, Ethical, and Empiric Perspectives,''	205	(18)
Ezekiel J. Emanuel
``When Self-Determination Runs Amok,''	223	(6)
Daniel Callahan
``When Abstract Moralizing Runs Amok,''	229	(4)
John Lachs
Discussion Questions	233	(1)
Suggestions for Further Reading	234	(3)
Section 8: Caring for Seriously Ill Newborns
Introduction	237	(6)
``Withholding Nutrition from Seriously Ill Newborn Infants: A Parent's Perspective,''	243	(5)
Emily D. Miraie
Mary B. Mahowald
``Decision Making in the Nursery: An Ethical Dilemma,''	248	(9)
Charlotte Jones
John M. Freeman
``Discontinuing Life Support in an Infant of a Drug-Addicted Mother: Whose Decision Is It?''	257	(6)
Renu Jain
David C. Thomasma
Discussion Questions	263	(1)
Suggestions for Further Reading	263	(4)
Section 9: Death and Managed Care
Introduction	267	(7)
``End-of-Life Treatment in Managed Care: The Potential and the Peril,''	274	(6)
Steven H. Miles
Eileen P. Weber
Robert Koepp
``Managed Care and Managed Death,''	280	(5)
Daniel P. Sulmasy
``Dying in 559 Beds: Efficiency, `Best Buys,' and the Ethics of Standardization in National Health Care,''	285	(11)
Margaret P. Battin
Discussion Questions	296	(1)
Suggestions for Further Reading	297	(2)
Glossary	299	(5)
Index	304