Gastonguay, Paul R.

English

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The Linacre QuarterlyVolume 44 | Number 4 Article 1611-1-1977[Book Review of ] Death, Dying and the BiologicalRevolution: Our Last Quest for Responsibility byRobert M. VeatchPaul R. GastonguayFollow this and additional works at: http://epublications.marquette.edu/lnqPart of the Ethics and Political Philosophy Commons, and the Medicine and Health SciencesCommonsRecommended CitationGastonguay, Paul R. (1977) "[Book Review of] Death, Dying and the Biological Revolution: Our Last Quest for Responsibility by RobertM. Veatch," The Linacre Quarterly: Vol. 44: No. 4, Article 16.Available at: http://epublications.marquette.edu/lnq/vol44/iss4/16describe a method characterized by "uncompromising rationalism " and "deduc-tive reasoning_ " Modern developments regarding natural law "metaphysical pre-suppositions" or other revisions of Catholic theological ethics by its more recent proponents pass by unremarked . The final selection of the book dese rves special note. By dealing with the role of medicine in society and with the e ffective and equitable distribution of m edical resources, it raises social justice issues which have become particularly acute for Western medicine. Two authors, Charles Fried and Garvan Kuskey, take up the question of wheth er there exists a "right to health care." In so doing they address explicitly and commendably the problematic concept of a " right" itself, a concept which has been crucial but submerged in other chapters, e.g., abortion and in-formed consen t. This collection is a use ful one in that it directs our attention to a variety of well-informed and articulate discussions of medical e thics . Its particular value lies in the fact t hat it educates the reade r to examine these discussions critically. - Lisa Sowle Cahill Assistant Professor of Theology, Boston College Death, Dying and theBi%gica/ Reyo/ution.· Our Last Quest for Responsibi/ity Robert M. Veatch Yale University Press, 92A Yale Station, New Haven Conn. 06520, 1976. ix + 323 pp., $12.95. As the director of the research group on death and dying at the Hastings Center, Robert Veatch has gained immense knowledge and perspective on the topic of this book. The result has been this enormously valuable publication. Broad in scope, direct and stimulating in style, the book surveys the de finition and technology of death , the refusal of treatment, truth-telling, organ donation, and several related issues_ Each is presented in depth, with the end result being Veatch's conception of a Public Policy based on philosophical , social, and legal parameters that are easily understood, although undoubtedly debatable. After a brief synopsis of the statistical data on dying and related costs, he analyzes four levels in the definition of death debate: the formal analysis of the term ' death,' then the concept, locus, and criteria of death . He calls for "a public policy ... that will enable us to know who should be treated as alive and who should be treated as dead." (p. 55) He then compares four such policy proposals presently rece iving consideration. On p. 76 he presents a valuable insight into the statutory difficulties, by formulating his own stature; the emphasis is on the patient's pre-stated opinions, or those of nearest relatives. Veatch is consistently cautious to protect the individual 's rights and wishes. The book is well documented with legal case histories, including a complete analysis of the Karen Ann Quinlan case. He presents a thorough analysis of the 'Living Will,' pointing out deficiencies which few care to admit. He then presents his own guidelines toward the development of such a document_ Perhaps the most valuable asset of this book is its lack of reluctance to offer precise positions on issues, most of which may polarize its readership. 1) "Terms November, 1977 373 such as 'brain death' or 'heart death' should be avoided because they tend to obscure the fact that we a re searching for the meaning of the death of the person as a whole." (p. 37) He analyzes such concepts as social integration and conscious· ness as criteria for life. " I ... believe that death is most appropriately thought of as the irreversible loss of the embodied capacity for social interaction." (p. 42) 2) "Physicians in the states that do not authorize brain·oriented criteria for pro· no uncing death who take it upon themselves to use those criteria . •. . in my opin' ion , should be ... prosecuted." (p. 61) 3)" . . . most people writing in the fi eld ... are careless in distinguishing between the whole brain and the cerebrum and the functions of each." (p. 71) 4) If it is deemed that someone is in an irreversible coma and 'dead,' why do physicians feel compelled to turn off the oxygenator before pronouncing death , then turn it on again to prese rve organs for transplant? 5) "When we accept active killing of the dying we are indeed stepping onto a slippery slope. We had best know very well how to get off that slope short of crashing to the depths of moral depravity." (p. 88) But he believes that "in some individual cases, active inte rven tion m ay still be m ora ll y defensible." (p. 93) 6) "I would propose adding 'ordina ry' and 'extraordinary' to 'euthanasia' as words that should be banned fro m further use. It is clearer simply to speak of morally imperative and elective m ea ns or of required and expandable means." (p. 110) He also warns against the terms ' m eaningful ex istence' and 'death with dignity. ' 7)" .. . the decision to allow dying patients to die or actively bring about their deaths should never be left to the individual physician. " (p. 172) He believes that the physician "has no special competence for this kind of decision m aking." (p. 183) "Physicians, at least nonpsychiatric physicians, are not trained in determin· ing what is in t he patient's interest. " ( p. 217) Although minor liabilities ex ist (such as the confusing Table 2) and a few debatable positions are presented, the book is an essential component of any library in m edical ethics. The reader is guided through a logical sequence of steps toward a Pu blic Policy, and is given the option of acceptance or repudiation. Whichever optio n is se lected, one is given the necessary legal, medical , and ethical bases for dec ision'making. My one reservation, and it is not a strong o ne, is that in his emphas is on the patie nt's right to choose, Veatch does not allow enough room for the fact that despondency and other temporary behavioral anomalies may induce a patie nt to ask for things which he does not really want. It is common for a patient to ask to die, when in fact he really means "Please assure m e that it will not be painful, " or "Please give m e comfort and just let m e talk ." - Paul R. Gastonguay Department of Biology, Stonehill College BOOKS RECEIVED Case Studies in Medical Ethics. Robert M. Veatch. Harvard University Press, Cam· bridge, Mass ., 1977, vii + 421 pp ., $15.00. A Christian View of Homosexuality. John W. Drake ford . Broadman Press, Nash· ville, Tenn., 1977,140 pp., no price given. Death, Dying, and Euthanasia. D. J. Horan and D. Mall, editors. University Pub· lications of America, Washington, D.C., 1977, xxii + 821 pp. , no price given. The Homosexual Question. Marc Oraison. Harper & Row, New York, 1977, 132 pp. , $4.95 . Homosexuals in History. A. L. Rowse. Macmillan Pub. Co., New York, 1977, xiii + 346 pp., $12.95 . 374 Linacre Quarterly 

[Book Review of] \u3cem\u3eDeath, Dying and the Biological Revolution: Our Last Quest for Responsibility\u3c/em\u3e by Robert M. Veatch

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[Book Review of] \u3cem\u3eDeath, Dying and the Biological Revolution: Our Last Quest for Responsibility\u3c/em\u3e by Robert M. Veatch

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