In 'Critical Care Ethics', David F. Kelly describes and analyzes some of the major ethical issues facing American hospitals today and proposes practical approaches by which hospitals may ethically and legally resolve them. The author includes both theory and application in a way which insures accessibility to those without a background in moral philosophy or moral theology. The book's major emphasis is on the resolution within the American hospital of the practical question of forgoing treatment. Its central thesis is that a consensus has arisen in American medical ethics concerning the ethical and legal rightness of forgoing medical treatment in some circumstances. The present consensus is based on three pillars. The first two of these are ethical principles and distinctions arising from Catholic medical ethics, which have been generally accepted in American hospital ethics and American law. The third is the development of American law itself. Together these three bases have resulted in general agreement that Americans have the right to refuse treatment for themselves, and that, with some reservations, they have the right to forgo treatment for others as well. These issues are developed in detail, including application to the question of medical nutrition and analysis of the decision. In addition, there are chapters on pain, pain management, ethics committees, and the problems of resource allocation. The final chapter attempts to point out some of the difficulties inherent in allocation arguments and criticizes the way in which they are so often made by many ethicists and religious leaders.
