An important contribution in the burgeoning literature relating to the delivery of medical care, and to the broader question of responsible decision-making in those social areas where tragic choices have to be made. The effort is an excellent example of research into, and therapy for, an important social process.

"An important contribution in the burgeoning literature relating to the delivery of medical care, and to the broader question of responsible decision-making in those social areas where tragic choices have to be madea. The effort is an excellent example of research into, and therapy for, an important social process."

--Edward Chase, "Camden Law Journal"

This volume surveys the clinical, ethical, religious, legal, economic, and personal dimensions of decision making in situations when the choice is either to extend costly medical treatment of uncertain effectiveness, or to terminate treatment, thereby ending the patient's life. Contributors from a wide range of disciplines offer perspectives on issues ranging from the definition of medical futility to the implications for care in various clinical settings, including intensive care, neonatal and pediatric practice and nursing homes. An important contribution toward the more humane and consistent handling of these situations, Medical Futility will be obligatory reading for health care professionals, students, and scholars concerned with ethical standards in medical care.

In this eye-opening look at the doctor-patient decision-making process, physician and law professor Jay Katz examines the time-honored belief in the virtue of silent care and patient compliance. Historically, the doctor-patient relationship has been based on a one-way trust--despite recent judicial attempts to give patients a greater voice through the doctrine of informed consent. Katz criticizes doctors for encouraging patients to relinquish their autonomy, and demonstrates the detrimental effect their silence has on good patient care. Seeing a growing need in this age of medical science and sophisticated technology for more honest and complete communication between physician and patients, he advocates a new, informed dialogue that respects the rights and needs of both sides.

In a new foreword to this edition of "The Silent World of Doctor and Patient," Alexander Morgan Capron outlines the changes in medical ethics practice that have occurred since the book was first published in 1984, paying particular attention to the hotly debated issues of physician-assisted suicide and informed consent in managed care.