This book demonstrates that moral reasoning can provide practical help in making judgements about how to handle particular clinical cases. It clearly explains the way in which conflicting moral considerations must be taken into account in medical decision-making and how their weight can be increased or decreased by specific factors. One of the book's greatest strengths is the cases - forty, all based on actual cases the author has encountered - which are constructed to convey the complexities of real-life support cases. They are difficult cases whose presentation and discussion will challenge readers, clarify the ethical issues involved, and indicate how theory and practice can be integrated.

The first four chapters deal with moral theory, the last three chapters present cases and apply theory to their resolution. The author's approach is pluralistic in that it supposes that there are many different moral appeals that are irreducible to each other, often in conflict with each other, and yet necessary to complement each other. It is casuistical in that it attends to the range of differences between particular cases and attempts to apply appropriately the different moral appeals to particular cases in different ways.