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vi Contents Chapter 5 Advance Directives 66 Chapter 6 Hydration and Nutrition 87 Chapter 7 Physician-Assisted Suicide and Euthanasia 118 Chapter 8 Medical Futility 133 Glossary 155 Cases Cited 159 References 161 Index 173 ACKNOWLEDGMENTS I WISH first to acknowledge the essential role played by the St. Francis Health System, a multi-institutional system of hospitals and nursing homes owned and run by the Sisters of St. Francis of Millvale, Pennsylvania, and to the remarkable people who worked there prior to its closing for financial reasons in 2002. Without my work at St. Francis this book could not have been written. The people of St. Francis welcomed the discussion of ethics and welcomed me; they were patient as I tried to learn what real hospitals were about. I especially acknowledge John Hoyt, director of critical care medicine and chair of the ethics committee. It was he who hired me for the sabbatical I took at the hospital in 1989 and 1990 and then arranged for me to continue as a staff ethicist. Duquesne University and its people have been equally important in supporting this book and the work that led up to it. The university gave me a sabbatical grant to write Contemporary Catholic Health Care Ethics, and while on sabbatical, I did most of the work for this book as well. I am thankful to the Duquesne administration, to Michael Slusser, chair of theology, and to present and past deans, provosts, and presidents. They have recognized that medical ethics needs both theory and practice and have been greatly supportive of Duquesne’s Health Care Ethics Center. I am grateful to Aaron Mackler, colleague in the Theology Department and associate director of the Health Care Ethics Center, who took over the administration of its graduate degree programs while I wrote. He also read the previous book and the major additions to this one, making suggestions for improvement. – vii – ...