Table of Contents
Preface xi
Introduction 1
Chapter 1 Hospice Care 3
Origins of Today's Modern Hospice Concept 3
Cicely Saunders and the First Modern Hospice 8
Elisabeth Kübler-Ross 10
The Avoidance of Death 12
The Present Re-Awakening 13
Newer Developments 14
Goals of Hospice Care 15
Principles of Hospice Care 22
The Hospice Code of Ethics 29
Summary 43
Chapter 2 Ethical Considerations and Their Development 47
Direction and Focus of These Considerations 47
Convergence of Thought and Development of Focus 48
Aristotle: The Nichomachean Ethics 48
Thomas Aquinas: The Medieval Synthesis 52
Summary of Ancient and Medieval Emphases 56
The Hippocratic Writings: Medicine's Early Documents 57
Philosophical Considerations 59
Immanuel Kant: Deontological or Obligation-Based Theory 60
Utilitarianism and Consequentialism in Retrospect 62
W. D. Ross: Theory of Prima Facie Duties 64
Positive and Negative Rights 66
Mid-Twentiem-Century Growth in Biomedical Ethics 67
The Principles Grounding Modern Bioethical Considerations 69
Autonomy 69
Nonmaleficence 71
Beneficence 72
Justice 73
Covenant Responsibility 75
Virtue Ethics: A Return to the Beginning 79
Summary 84
Chapter 3 The Dark Night of the Soul 87
Mysticism 87
John of the Cross: Sixteenth-Century Spanish Mystic 91
Sixteenth-Century Spain: Literature and Milieu 93
The Spanish Inquisition 93
The Spanish Mystics: John's Place 95
Ascent of Mount Carmel and Dark Night of the Soul 96
Dark Night: The Poem and the Purpose of John's Commentaries 97
The Structure of Ascent and Dark Night: Major Emphases 102
The Active Night of Sense 106
The Active Night of Spirit 108
The Passive Night of Sense 111
The Passive Night of Spirit 114
Natural Human Passions-Acceptable or To Be Negated? 116
Does John Negate Our Natural Intellect? 119
Virtue as an Expression of the Contemplative Soul 123
Modern Authors 125
Women, Spirituality, and Health Care 128
Summary 133
Chapter 4 Practitioners and the Dark Night 135
Medicine and the Law-Influence over Health Care Practitioners' Decision-Making 135
Personal Practice: Practitioners and the Dark Night 137
One Man's Personal Experience-Spirituality and the Health Care System 141
Delving into Essentials: From Nursing to Priesthood-One Man's Journey 146
Practitioners: Discernment, Honesty, and Virtue-Centered Practice 150
Women's Issues: A Personal Note 150
Hospice, Humility, and a Virtuous Professional Life 151
The Process of Discernment 155
Personal Background and Point of View: Our Responsibility 158
Summary 164
Chapter 5 Patients and the Dark Night 167
Acceptance, Letting Go, and Resolution of "Unfinished Business" 168
Theologian and Patient: Meeting of the Mind and Heart 170
Attachment in Our Modern Society 176
Practitioners' Approach to Patients and Families in Light of the Dark Night 180
Additional Thoughts and Synthesis for Practitioners 186
Summary 188
Chapter 6 Summary and Conclusions: 191
Contemporary Spirituality for Terminal Illness 191
General Overview 191
The Documents of Vatican Council II 194
The Consistent Ethic of Life 197
Further Reflections on The Consistent Ethic of Life 200
The Pope Speaks 207
Conclusion 210
Notes 213
References Consulted 233
Index 251
