Elder Mistreatment: Ethical Issues, Dilemmas, and Decisions.

Johnson TF, ed. Binghamton, NY 13904-1580, The Hayworth Press Inc, 1995 hart/cover, 190 pp, $34.95.

The mistreatment of older adults, manifested by abuse or neglect, is an ugly matter that presents difficult problems for the client, family, health care professionals, and society at large. Furthermore, this problem is expected to increase as America s older population increases. This book is written with the intent of linking ethical theory to practice in the identification, evaluation, and management of elder mistreatment.

Three case studies involving ethical issues in elder mistreatment are presented. The cases involve neglect by caregivers, financial exploitation, assault and battery, and psychological abuse. Among the ethical issues raised are the values of self-determination, societal responsibility to protect citizens, family responsibilities to protect family members, and the responsibilities of health care professionals to provide care and do no harm.

Professionals from a wide range of disciplines including nursing, medicine, law, social work, religion, and ethics analyze each of the three cases from their perspective. They define their roles and address each dilemma. This is informative and interesting in that the reader can compare similarities and differences in approach. The final chapter is written by an ethicist who suggests ways for a multidisciplinary team to communicate to reach greater consensus when making an ethical decision.

I recommend this book to members of all health fields. It covers in depth the major ethical topics of autonomy, beneficence, legal competence, and justice, yet remains practical by discussing constraints to ideal solutions. Physical therapists who practice in home care and in nursing homes would find special benefit.

Byron E Bork, MA, PT The University of Iowa Iowa City, Iowa