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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.
Weigh pivotal healthcare ethics, law, and public policy issues that resulted in tipping-point legal actions Weighing the ethical considerations in healthcare and drug issues can be emotionally difficult and mentally challenging. Drugs, Ethics, and Quality of Life: Cases and Materials on Ethical, Legal, and Public Policy Dilemmas in Medicine and Pharmacy Practice is a fascinating casebook that clearly discusses the most contentious ethical conflicts that resulted in legal actions. This easy-to-read text provides all sides of controversial real-life cases that provoke spirited debate while teaching the fundamentals of pharmacy law and ethics. The book is a unique exploration into the basic principles of bioethics, end of life care, and drug research. Drugs, Ethics, and Quality of Life explains in detail the concepts of ethics, quality of life, beneficence, nonmaleficence, autonomy, and justice. Recent cases provide illuminating backdrops for the exploration of these concepts, making them easily understood. A special introduction includes important information about ethics and the pharmaceutical code of ethics. Two appendixes provide further opportunities for discussion and the examination of law and decisions, and resources about drug use decisions and situations. This thought-provoking textbook plainly shows the crucial role ethics plays in today’s society. Ethical topics explored in Drugs, Ethics, and Quality of Life includes legal cases on: tobacco COX-2 inhibitors medical marijuana the “morning after” pill and other emergency contraceptives pain medications and palliative care drugs physician-assisted suicide drug use in medically futile situations gene therapy Drugs, Ethics, and Quality of Life is valuable, insightful reading as well as a good adjunct text for pharmacy students, pharmacists, medical students, physicians, bioethicists, students interested in bioethics, institutional ethics committee members, and anyone interested in bioethics.
Continuous sedation until death (sometimes referred to as terminal sedation or palliative sedation) is an increasingly common practice in end-of-life care. However, it raises numerous medical, ethical, emotional and legal concerns, such as the reducing or removing of consciousness (and thus potentially causing 'subjective death'), the withholding of artificial nutrition and hydration, the proportionality of the sedation to the symptoms, its adequacy in actually relieving symptoms rather than simply giving onlookers the impression that the patient is undergoing a painless 'natural' death, and the perception that it may be functionally equivalent to euthanasia. This book brings together contributions from clinicians, ethicists, lawyers and social scientists, and discusses guidelines as well as clinical, emotional and legal aspects of the practice. The chapters shine a critical spotlight on areas of concern and on the validity of the justifications given for the practice, including in particular the doctrine of double effect.
By providing an interdisciplinary reading of advance directives regulation in international, European and domestic law, this book offers new insights into the most controversial legal issues surrounding the debate over dignity and autonomy at the end of life.
Continuous sedation until death (sometimes referred to as terminal sedation or palliative sedation) is an increasingly common practice in end-of-life care. However, it raises numerous medical, ethical, emotional and legal concerns, such as the reducing or removing of consciousness (and thus potentially causing 'subjective death'), the withholding of artificial nutrition and hydration, the proportionality of the sedation to the symptoms, its adequacy in actually relieving symptoms rather than simply giving onlookers the impression that the patient is undergoing a painless 'natural' death, and the perception that it may be functionally equivalent to euthanasia. This book brings together contributions from clinicians, ethicists, lawyers and social scientists, and discusses guidelines as well as clinical, emotional and legal aspects of the practice. The chapters shine a critical spotlight on areas of concern and on the validity of the justifications given for the practice, including in particular the doctrine of double effect.
Critical care is a highly complex area of medicine, in which 30% of patients are expected to die. Developments in law have had a major impact on treatment expected and received in the ICU. However, the law and ethics surrounding clinical practice are not always clear, and generate much concern for those working in intensive care. This book outlines how the law has changed and the impact this has had on the practice of intensive care medicine. Particular clinical scenarios are outlined to illustrate real problems that develop during normal clinical practice, with discussion of the legal and ethical framework that arises from these scenarios, and possible solutions to the problems that are identified. It also covers issues such as consent, who decides children's rights, living wills, withholding and withdrawing of life-saving care, whether there is a right to insist on treatment, definitions of 'death', ICU funding, and the breaking of bad news. The emphasis is on practical information that will inform all professionals involved with patients admitted to the ICU, including doctors, nurses and allied health professionals.
Decisions at the End of Life is the last volume in a trilogy on Aging conceived for the International Library of Ethics, Law, and the New Medicine. Leading scholars from a range of disciplines examine some of the most emotive topics in the study of aging: assessing quality of life, improving end-of-life care, palliative care, euthanasia, and consent to research.

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