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Loane Skene, Sydney, Butterworths, 1998, 299 pages, A$ 54.
The interdisciplinary conjunction between law, medicine and ethics has been a notable development over the last twenty or thirty years, particularly in the UK and common law countries such as Australia, New Zealand and Canada. Many law schools in Australia now have flourishing centres and institutes where law and medicine and ethics are brought into dialogue with each other and there are also a number of statutory bodies serving the same purpose. Monash University in Melbourne, for example, has been the home of the Centre for Human Bioethics under the guidance of Professor Peter Singer (soon, alas to move to Princeton) and Dr Helga Kuhse, and the law school at the same university has recently founded an Australian Institute for Health, Law and Ethics. Again, the law school at Melbourne has established a flourishing postgraduate course in law, medicine and ethics under the direction of Associate Professor Loane Skene.
Professor Skene has been one of the movers and shakers in this movement and in her most recent book she is able to draw on a vast fund of legal and medical experience. The book is very much a compendium of information bearing upon the rights and duties of doctors and their patients and it is directly practical in its aim of enabling all the parties involved in health care situations to find out where they stand. The author eschews any theoretical speculation about the larger controversial ethical issues and for the most part concentrates on the state of the law about the questions she discusses—consent to medical treatment, the doctor's duty to provide information, confidentiality, withdrawal of treatment, abortion etc.
For the most part Professor Skene is concerned with Australian situations and legal decisions but she also discusses relevant UK cases and opinions and her book would have considerable value for doctors and their patients, and lawyers, in the UK and other countries.
The book, as I have said, is a model of a practical compendium but, as a philosopher I would have liked to see a little more attention given to the larger ethical issues, especially on the vexed questions that arise a propos the withdrawal of medical treatment. These questions have been at the centre of much recent discussion in Australia. Again, Professor Skene says nothing about the special problems (regarding consent, the examination of women patients, the use of information gained in research etc) involved in medical treatment of indigenous Australians and New Zealanders. No doubt there are as yet very few legal cases in this area but we may be sure that it will be an important focus in the very near future.
However, one cannot cover every issue and there is no doubt that Skene's book admirably succeeds in its main purpose. It will certainly be welcomed by doctors and lawyers and, not least, by intelligent patients.
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