Medical Law, Ethics, and Bioethics for Ambulatory Care, ed 5.

Lewis MA, Tamparo CD. Philadelphia, PA 19103, FA Davis Co, 2002, paperback, 271 pp, illus, ISBN: 0-8036-0995-7, $24.95.

The authors' stated goal for this book is to provide "an adequate resource for the study of medical law, ethics, and bioethics" (pv) for those health care professionals practicing in the ambulatory care setting. The authors' stated goal is only partially met by this text. This introductory-level text is concise, well organized, and well written; however, the depth of the material is insufficient to function as an ethics resource for physical therapist clinicians or academics.

The authors address a breadth of ambulatory care topics and provide contemporary information on each topic. Each chapter opens with a well-written list of learning objectives and definitions of key terms. The initial chapters of the book discuss a variety of topics, such as medical practice management, legal and regulatory guidelines, public duties, consent, and medical records. These chapters provide an effective survey of the ambulatory care setting and would be helpful in introducing structural and cultural concepts to anyone considering a practice opportunity in ambulatory care. The later chapters provide preliminary information on topics that include allocation of scarce resources, genetic engineering, abortion, life, and death and dying. These later chapters would be helpful in exposing the new clinician to very important ambulatory care topics and should be effective in heightening practitioner awareness. This text would better serve as an ethics resource if the references for each chapter included citations drawn from the wealth of ethics literature.

The text includes 13 vignettes that provide examples of how the concepts in a specific chapter may be applied in practice. In addition, each chapter concludes with a series of thought-provoking questions. This combination of vignettes and questions could be beneficial so clinicians who are newly active in ambulatory care.

The appendixes at the end of this text provide convenient collections of information. Appendix I pulls together historical codes of ethics, including the Hippocratic Oath, the Geneva Convention Code of Medical Ethics, the Nuremberg Code, and the Declaration of Helsinki as well as codes of ethics from the American Association of Medical Assistants and the American Medical Association. The appendix concludes with the text to A Patient's Bill of Rights from the American Hospital Association. Appendix II is a collection of various sample documents that are applicable to ambulatory care practice. The bibliography is drawn from a variety of resources, including a wide variety of Web sites that offer the promise of ongoing currency of information. As stated above, however, the usefulness of this text as an ethics resource would be enhanced if the bibliography included references drawn from the philosophy and ethics literature.

This text has limited relevance to physical therapist practice outside of ambulatory care. However, those physical therapists who are considering practice opportunities in the expanding ambulatory health care market will gain an understanding of the practice culture of ambulatory care. Physical therapists in this practice setting who have ethical concerns would be better served by selecting from more in-depth physical therapy ethics literature.

Ernest Nalette, PT, EdD

Ithaca College

Rochester, NY

Dr Nalette is Associate Professor, Chair of Graduate Studies in the Department of Physical Therapy, and Director of Ithaca College's Rochester Center. He is a past member and former Chair of the APTA Ethics and Judicial Committee and has written several articles on physical therapy ethics.