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Medical Ethics: a Guide for Health Professionals.

Medical Ethics: A Guide for Health Professionals, edited by John F. Monagle and David C. Thomasma, (Aspen Publishers, 1988), 522 pages.

Reviewer: Juli-Ann Gasper, Associate Professor of Finance, Creighton University.

Medical Ethics is a collection of 38 essays relating to current issues in medical ethics. The editors stress that the much-debated issue of abortion is not included in the topic list in order to make way for the multitude of other issues which are on the cutting edge of ethics study in the medical field.

Organization of the chapters is logical. First are 21 chapters taking the reader from pre-conception issues of genetic engineering through discussion of disposal of tissue from donors and unidentified or unclaimed dead persons. These chapters are arranged in three sections, those for childhood, for adulthood, and for critical illness and death.

The second major structural component considers ethical issues facing individual practitioners, and then groups of professionals (medical societies, hospitals, licensing agencies, etc.). Finally issues of national impact are presented.

The third major structural component is a two chapter sequence presenting the principles of ethical analysis and a decision making model. Two important omissions from the text should also be included in this section. A historical review (Hippocrates, Kant, etc.) of how the medical professions arrived at the present dilemmas in balancing ethical issues would have been most welcome. In addition, it would have been very helpful to see a summarization of the general nature and status of legal opinions which have been rendered in the last several decades.

In my opinion, the latter 2 topics all belong at the beginning of the book, rather than at the end. The reader is tempted to forget about the last few chapters after having spent considerable time in the rest of the book (perhaps this is only true in academic settings where, all too often, we run out of time at the end of the semester to finish the text!?). The editors state that the book is for "practicing health professionals", and will be "especially helpful" for members of hospital ethics committees. It is my experience that the members of these committees are no better educated on the principles of ethical analysis than the typical physician, nurse, social worker, or business manager. Their experience has typically been that of having to analyze the issues, but without strong theoretical and philosophical study of the principles and methods needed to do this.

With the exception of the two aforementioned topics which were omitted and the editors' stated intention to ignore the abortion issue, the text coverage is extremely thorough. Two medical ethics committee members who examined the table of contents could find no other omissions of important topics.

John Monagle and David Thomasma have done a masterful job of editing in this reference book. In many multiple-authorship collections of articles, there is often overlap of topics, previously published material which authors have declined to update or improve, duplication of references, and inadequate indexing to give the reader access to the multitude of topics. This reference suffers from none of these weaknesses. The topic categories were well outlined with little duplication of subject discussion and remarkably little duplication of references (of which there are several hundred, when cumulated across chapters). Only three chapters are adaptations of previously published articles. The index is quite complete and easy to use.

A glossary of ethics and legal terms complete the contents of the book. The glossary again reflects the editors' intention that the readership for this text be limited to practicing medical professionals. Ethics, legal, and economics terms only are included in the glossary, with no medical definitions whatsoever. The editors state that the text is intended for interdisciplinary discussions, but apparently they mean interdisciplinary only within the fields of health study. Having grown up in a medical professional's family, this structure was not a hindrance to my use of the text, but I feel that medical terms should have been included in the glossary in order to broaden the audience. The text is a really good text which should be usable by a broad population, and could be used with some very minor corrections such as this one.

One of the advantages of being a book reviewer for this Journal is that the reviewer is invited to keep the copy used for review. Unfortunately, I have lost on this account. My father, a long-time medical ethics committee member, has repossessed this text. This is testimony to the excellent job of the editors. I recommend this text to those with some familiarity with medical vocabulary who are interested in the study of ethical questions.
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Author:Gasper, Juli-Ann
Publication:Journal of Risk and Insurance
Article Type:Book Review
Date:Jun 1, 1990
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