Medical Care at the End of Life

A Catholic Perspective

David F. Kelly

"Strong in clinical experience and engagement with patients and families, Kelly offers a Catholic perspective on hotly contested issues . . . An excellent introduction to many legal controversies and rulings in the matter of health care."
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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.

Table of Contents




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


Cases Cited




"This book provides an exploration of the critical thinking necessary for a wide audience to make fully informed decisions regarding end-of-life health care treatment decision. It is sufficiently detailed through narratives and the application of cases to the author’s own experience. Ethics committees, medical practitioners, patients and their families, and college bioethics classes will find the text useful for continuing education, clarification, and discussion."—Health Progress

"For those concerned about the ethical dimensions of caring for persons at the end of life, this book in valuable. In addition, it is indispensable for those who are seeking insight about Catholic moral teaching on these issues, and how that teaching has contributed to the broader secular conversation."—Vision

"Strong in clinical experience and engagement with patients and families, Kelly offers a Catholic perspective on hotly contested issues . . . An excellent introduction to many legal controversies and rulings in the matter of health care."—America

"David F. Kelly's Medical Care at the End of Life is an indispensable guide for any person concerned with this topic—which should mean everyone . . . the book contains such a balanced treatment of all of the issues at hand."—Catholic Library World

"Kelly brings his expansive knowledge of Catholic health care ethics, church teachings and legal precedent together to contribute a fresh perspective on end-of-life care."—Conscience

"This practical book will be a valuable tool for health care chaplains who must deal with these issues on a regular basis."—Rev. Jeffrey R. Funk, executive director, Healthcare Chaplains Ministry Association

"This book provides an excellent understanding of Catholic perspectives on medical care at the end of life. Kelly brings to his analysis a broad knowledge of medical ethics, a deep Christian wisdom, a cogent and convincing presentation, and a clear writing style."—Charles E. Curran, , Elizabeth Scurlock University Professor of Human Values, Southern Methodist University, and author of The Moral Theology of Pope John Paul II

"In Medical Care at the End of Life, David Kelly brings his usual blend of rich clinical experience, excellent theological and bioethical resources, and a high degree of common sense and wisdom to bear on problematic issues surrounding the care of people at the end of life. His discussion of these issues is thoughtful and practical, well-grounded in the ethical dimensions of the debates, and extremely pastoral in application. This is a very important contribution to these debates and will be helpful to many different audiences."—Thomas A. Shannon, professor emeritus of religion and social ethics, Worcester Polytechnic Institute


Supplemental Materials


About the Author

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.

192 pp., 5.5 x 8.5

Oct 2006

192 pp., 5.5 x 8.5

ISBN: 978-1-58901-112-0
Oct 2006

192 pp.

ISBN: 978-1-58901-367-4
Oct 2006

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