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A Campbell, G Gillett, G Jones. Oxford University Press, 2001, £19.95, pp 297. ISBN 0 19 558445 7
Medical Ethics, to quote the authors, is intended as a practical introduction to the ethical questions doctors and other health professionals meet. The book is divided into three main sections, Foundations, Clinical ethics and Medicine and society; each section is further subdivided into topics dealt with in a single chapter.
The first section deals very well with the basic background and theories of ethics and does not lay too much stress on the well established “four principles” (chs 1 and 2). I have rarely read such a seamless introduction to the underlying principles of medical ethics and teachers would do well to read this. Later chapters in this section deal with diverse cultures (ch 3) and the human body (ch 4). Of particular note here is the excellent treatment given to information, consent, confidentiality, and truthfulness; there is much to be gained here by the book’s intended audience. The chapter on the human body seems unusual in a book of this type, but is a well argued discussion of how the human body, both alive and dead, should be treated. This chapter also encompasses the topics of postmortem examinations and biopsies both of which are in the public mind at present; this discussion is clear and full of “common sense” and if taken to heart would, hopefully, avoid further public outcries on the matter of retained organs and biopsies. The discussion of the ethical problems of mixed cultures is an unexpected inclusion and there is reliance on more contemporary philosophy rather than on traditional arguments. The New Zealand background of the original edition shows through most obviously in this chapter but this does not detract from the arguments put forward.
The “meat” of the book, however, is in the second section (142 pages out of a total of 297). The “standard” topics of genetics, prenatal problems, birth, organ transplantation, AIDS, euthanasia, and brain death are all dealt with well and clearly, especially transplantation. The general format of the chapters is to briefly discuss the medical problems and then to introduce the ethical dimension. This ensures that a reader not familiar with a certain topic is reminded of the problems before entering into the ethical discussion. The chapters on genetics and ending human lives are particularly good in this respect. Two topics not commonly found in introductory texts are included in this section, namely, psychiatry and the problems with aging and dementia. Both are discussed sensitively and with compassion and are welcome inclusions in a text of this type.
The final section covers research ethics, justice, law and “trying new things”. This rather broad area is dealt with excellently and the rather oddly named chapter on “Trying new and unusual things” is highly recommended reading for anyone wishing to introduce new treatments (medical or surgical).
Overall, the book is well organised and, while it is an introductory text, there are ample references to sustain the authors’ arguments and for further reading. Case studies are used extensively throughout the text to illustrate the discussions. In my opinion, the authors have succeeded in producing a text that is a practical introduction to medical ethics. I would warmly recommend this book to all medical and nursing students and a copy should be in all medical libraries.
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