NONFICTION - Dec. 16, 1990

ETHICS AT THE BEDSIDE, edited by Dr. Charles M. Culver (University Press of New England: $19.95; 214 pp.) This is an excruciatingly painful--and sadly, important--book for anyone who doesn’t yet have the key to immortality. Culver has collected a dozen essays by medical ethicists around the country, members of a fairly new discipline who help families and the medical community make what are, quite literally, life-and-death decisions.

The dilemma is that the same technological advances that save lives can prolong suffering. Treatment--often delivered under the honorable guise of doing everything possible for the patient--can extend a terminally ill patient’s pain, for no reason except that the family, or medical policy, demands it. It’s almost impossible to imagine anyone reading this book unless he/she needs the information right this minute; if you can get through a chapter without tears, you should have your heart checked immediately. But the book teaches an important lesson to those faced with a medical crisis: In every instance, the ethicist tries to empower the family members, to get them to start talking and stop taking a doctor’s word as Holy Writ.