145 - By No Extraordinary Means: The Choice to Forgo Life-Sustaining Food and Water

By No Extraordinary Means: The Choice to Forgo Life-Sustaining Food and Water

Edited by Joanne Lynn

Bloomington, Indiana University Press, 1986. 272 Pp. $25.00.

This book grew out of a conference sponsored by the Society for Health and Human Values and fourteen other organizations, including the Presbyterian Church (U.S.A.). The authors, many of whom are well-known, represent a variety of fields. They assume that it is appropriate in most cases to use the techniques that supply nutrition and hydration to patients who cannot or will not eat. The question is whether these techniques should ever be withheld. If so, why? And who should decide?

Twenty-seven articles are organized in five parts. Part one treats legal standards, medical procedures, observation of patients, and physician attitudes. Part two consists of eight articles addressing moral issues from different points of view. Part three contains three articles about legal perspectives, and part four considers types of cases, for example, newborns and the permanently unconscious. The last part considers the celebrated case of Claire C. Conroy.

It is unfair to the nuances of the book to generalize. Nonetheless, amid warnings about slippery slopes and caution about legal standards, there is general agreement that it is morally permissible to withhold nutrition and hydration in some instances. Within this general consensus, there are disputes, for example, whether nutrition and hydration are to be considered medical procedures or nourishment to sustain life.

Despite its misleading title (many think extraordinary/ordinary terminology should be discarded), the book fully airs an anguished and vexing dilemma. Many readers will want a shorter treatment of the subject.

Charles M. Swezey, Union Theological Seminary in Virginia, Richmond, Va.