Now and at the Hour of Our Death | Making Moral Decisions at the End of Life

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This book addresses important moral questions people commonly face when they or their loved ones experience life-threatening injuries, end-stage illnesses, or advanced old age.

Due to modern medical technology, patients and their family members often confront such questions as: What medical procedures are morally required, and what procedures are optional? Is providing food and water to a patient an optional medical treatment, or is it basic care necessary for all human beings?  What roles do conscience, quality of life, pain, and financial burden play in end-of-life decision-making?  With a clear, concise question-and-answer format, this book provides moral answers to these questions, and many more, in the light of Catholic teaching based on Scripture and Sacred Tradition.

Without knowledge of medical science or familiarity with common medical terminology, people can be misled or confused by authoritative-sounding medical assertions, even immoral ones—thus the need for this easy-to-use guide. In these pages, readers can quickly find the most pressing end-of-life questions along with answers consistent with the moral teachings of the Church. The book uses practical reasoning to reach proper moral conclusions based on correct moral principles. Timely and highly practical, this book addresses issues everyone will eventually face, showing that making good moral decisions leads to happiness now and at the hour of our death.

Nikolas T. Nikas is the President and General Counsel of Bioethics Defense Fund. He has litigated constitutional cases, drafted model pro-life legislation, testified in the United State Senate on abortion and the First Amendment, and spoken at many prominent law and medical schools on the full range of bioethics issues, including making moral decisions at the end of life. He anchors his work in the natural law and the compatibility of faith and reason.

Bruce W. Green is a former constitutional and pro-life litigator, dean, and law professor. He serves as Special Counsel to the Bioethics Defense Fund and is a regular speaker and teacher in Catholic parishes. He is a lay member of the Order of Preachers (O.P.).


“This book presents a clear, concise summary of the Catholic Church’s moral tradition surrounding end-of-life decision-making. It also provides a well-organized, practical resource for patients and their families that can be pulled off the shelf for an immediate answer to the questions that inevitably arise during a time that can be overwhelming. It is a book that should be kept handy.”
Deacon Stephen Doran, M.D., Neurosurgeon, Author, and Bioethicist

“In these contentious times, when activists and the media seek to redefine assisted suicide as ‘death with dignity’, Nikas and Green provide a practical, compassionate primer to help readers make informed and moral decisions at one of the most difficult times faced by families or caregivers. This is an empowering resource for any reader confronting the dilemmas that must be confronted during the final stages of our earthly sojourn.”
—Wesley J. Smith, Author, Culture of Death: The Age of “Do Harm” Medicine

“Sooner or later, every family will need this book. End-of-life questions are gut-wrenching. This book provides convenient access to the collected wisdom of history’s deepest thinkers on these topics. Regardless of religious conviction, this book should be closely reviewed and kept readily available to assist decision-makers through those darkest moments.”
 Ronald J. Rychlak, Distinguished Professor of Law, University of Mississippi

“Two doctors of jurisprudence present a mini-Summa consisting of 123 questions and answers about moral questions at the end of life.  Their simple and direct answers make the case for an informed Catholic viewpoint on death and dying, guided by the Catechism of the Catholic Church and mentored by the likes of Aquinas, Augustine, and Saint John Paul II. A useful and timely work given the increasing acceptance of euthanasia in the secular world.”
—Donald DeMarco, Author, Architects of the Culture of Death

“Twin perils await us at the end of life in our callous neo-pagan world: the pressure to usurp God’s prerogative of determining the moment of death and the pressure to subject oneself to disproportionate and extraordinary treatment. Nikas and Green provide a much-needed map—well drawn and clearly labelled—for the wary traveler, freeing him to focus on his proper business of dying in the grace of God.” 

—Alan Fimister, Assistant Professor of Theology, Holy Apostles College and Seminary 

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