[Book Review of] By No Extraordinary Means: The Choice to Forego Life-Sustaining Food and Water , edited by Joanne Lynn
Year: 1987
Type: book-review
Abstract: + l 7l l'I', Sl51111I'd"(/c'k, Thi s book is composcd of 27 papers dcli\'ercd at a symposiu m on the et hi eal.medica l and lega l aspec ts of pro\'iding Ilutriti o n and fluid s to pati e nt s.The sympos iulll \\'as s r o ll :-.or~d by a number of m ed ical.et hica l and lega l organizatio ns in res poll se to til l' :"l'\\' .krseyS upreme Court dccision III III (' Ma{fl'l' ,,(Cla;l'e COIIWI'.Th e papcrs are of tllle\ en 4ualit\'.and most of th c m lea ve somet hi ng to be d esircd because of th e ir ex trc me hre\'it\" Hardl \' anI" of th c papers t ouc h. with any profundit y. thc m ajor Icgal.ethi cal and med ical issues invo lved in thc provi sio n of foo d a nd wa te r to pati e nts.Gc ncrall\'.the papers hol d that ass ist ed fee ding is a medica l t reatmcnt.that food and water ca n he withdrawn o r re,jected when they are judged to be too burdensom e .an d that th e prese nt tre nd among American sta tc court s to permi t th e ir w ithdra wa l frolll I110 re and more classes or pat icll t s i:-.unobjectionabl e.The book conta ins a num ber of articles w hich co ns id e r the medical a nd c lin ical aspect s of feeding.The e mphasi s of the se artic les is o n th e m edica l com pli cation s in\'() II'cd in th e provision of assisted feedi ng.It is unfortunat e thai a wid e r ran ge of \'iell'point s was not represe nt ed in th e medica l a rt icles.view points s ugges ting Ih a l virtu a lly all pati ents can he sus tain ed Ih rough e ith e r en te ral or parent era l feeding hecau se of remarka hle recent advances.Ron a ld Cranford adm it s th a t the re mo val o f food a nd water certai nly hrings death.He ca nnot see how anyone who has lost co ns cious ness has an y inte res ts w hat soc\'cr.and he Ih erefore beli eves that re mo vin g fo od and water s h o uld not be prohl e matic, He savs thi s eve n though he ad mit s that m ost pati c nt s who are pe rma ne ntl y un co nscious ha\'e hea lth\' bodies and cannot be co ns id e red as term in a ll y ill becausc ofcontcmporarv C!e\'c!opme nt s ill med ic in e. Th ese views s how that man y who are prom oti ng the remO\'al of food and wa ter from th e comatose suffer from a se riousl y flawcd anthropo logy and are un c ritica l philosophica ll y.A number of articles cons ider the Icgal aspects of ass ist cd feeding.and \'irtuallv al l of th e m argue for th e pure content less pati e nt autonom y model of mcd ica l decision-making .This view po int is dubiou s juris prudentiall y bccause it und c rmines the res ponsibilities of the stat e and the medica l profess ion to prov id e ord inary and c ustomary care to pati e nts.This model is even more objectionable becausc it destroys the covcnanta l modcl of d ccision-making bet ween pati e nt and ph vs icia n .The covena ntalm odc l hold s that hoth th e hea lth care prov id e r a nd pati e nt ha ve obligations t o pr o m otc hea lth .It 1'C 4uires hoth pa rtie s to ha ve input into treatm e nt d ecis ion s so that the y ca n bo th fulfill th e ir responsibilities .The hea lth ca re pro vi d e r ha s a profess ional o bliga ti o n to adnlncc t he goals of healin g as far as po ss ible.and the pati c nt ha s a dUl y to accept o rdinary hurd ens to protect hi s or he r li fe and t o promot e the good of hea lth in ge ne ra l.The purc cont c ntlc ss patic nt a utonom y mod e l of d ec isio n-makin g ign ores th ese ob ligations.a nd makes the ph ys ici an th e servanl of the pati e nt who is often the lea s t well-inform ed and least capahle of makin g medica l decisions.
Author: Robert Barry
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2765619857