"... compelling.... This book might have been called 'No Easy Answers.' Each of the contributors writes with undisguised urgency.... [W]e should face up to these issues now. By No Extraordinary Means will serve as an impetus and guide." -- New York Times Book Review"This fine new book... thoughtfully written... well edited and cohesively integrated... will be valuable for physicians, nurses, nutritionists, attorneys, members of the clergy, policy makers, and members of the general public." -- New England Journal of Medicine

Foreword

ix

Julia

Joseph Quinlan

Paul Armstrong

Contributors

x

Introduction and Overview

1

(10)

Joanne Lynn

Part I The Issues

Historical Overview: Law and Public Perceptions

11

(10)

Alexander M. Capron

The Medical Procedures for Providing Food and Water: Indications and Effects

21

(8)

David Major

Observations on Nutrition and Hydration in Dying Cancer Patients

29

(10)

Phyllis Schmitz

Merry O'Brien

An Empirical Study of Physician Attitudes

39

(8)

Kenneth Micetich

Patricia Steinecker

David Thomasma

Part II Considerations in Formulating a Moral Response

Must Patients Always Be Given Food and Water?

47

(14)

Joanne Lynn

James F. Childress

Public Policy and the Cessation of Nutrition

61

(6)

Daniel Callahan

When Is It Morally Justifiable to Discontinue Medical Nutrition and Hydration?

67

(17)

James F. Childress

The Symbolic Significance of Giving to Eat and Drink

84

(5)

Ronald A. Carson

Perspectives from Catholic Theology

89

(10)

Edward J. Bayer

Perspective of a Jewish Physician

99

(9)

Michael Nevins

On Killing Patients with Kindness: An Appeal for Caution

108

(9)

Alan J. Weisbard

Mark Siegler

Forgoing Life-Sustaining Food and Water: Is It Killing?

117

(18)

Dan W. Brock

Part III Perspectives on the Law

Terminating Food and Water: Emerging Legal Rules

135

(15)

Ron M. Landsman

Legal Perspectives on Withdrawing Fluids and Nutrition: The New York Experience

150

(5)

Alan J. Weisbard

Perspectives of a Criminal Prosecutor

155

(8)

Bernard L. Siegel

Part IV Special Considerations for Particular Populations

Elderly Residents of Long-Term Care Facilities

163

(17)

Joanne Lynn

Forgoing Life-Sustaining Food and Water: Newborns

180

(6)

Joel Frader

Patients with Permanent Loss of Consciousness

186

(9)

Ronald Cranford

Caring for the Permanently Unconscious Patient

195

(7)

Gilbert Meilaender

The Competent Patient Who Decides Not to Take Nutrition and Hydration

202

(14)

Dan W. Brock

Joanne Lynn

Those Who Provide Medical Care

216

(11)

Joanne Lynn

Part V In re Claire C. Conroy: A Case Study

In re Conroy: History and Setting of the Case

227

(9)

Jeff Stryker

Conroy on Appeal: Two Contrasting Perspectives by the Appellate Court and the State Supreme Court

236

(9)

Robert C. Cassidy

The Conroy Case: An Overview

245

(4)

William Strasser

The Role of the Guardian Ad Litem

249

(7)

John J. DeLaney, Jr.

Role of the Public Advocate

256

(4)

Joseph H. Rodriguez, Jr.

The Conroy Decision: A ``Not-So-Good'' Death

260

(7)

Russell L. McIntyre

Afterword: Update since Conroy: 1985--1988

267

(41)

Jacqueline J. Glover

Joanne Lynn

Selected Bibliography

308

(1)

Index

309

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