Edited by G Roberto Burgio and John D Lantos, Amsterdam, Elsevier Science BV, 1998, 171 pages, £93.10.

This book is an updated version of the record of a symposium on pediatric bioethics held in Pavia in 1994 and published later that year. The first edition well deserved its favourable reception and it is not surprising that the editors felt the need to restock the shelves and our minds with a refit rather than a reprint. New contributors have appeared, mainly from Italy, and the USA, to cover the ethical aspects of rapidly developing areas of paediatric biotechnology (stem cell transplantation, cancer genes, and gene therapy). There is a new chapter on vaccination (Diekema, Marcuse) which puts well the ethical quandary between parental autonomy (“don't risk my child”) and the public good (maintain herd immunity). The paper on therapeutic trials is now expanded to consider evidence-based medicine (EBM) as illustrated from their previous analysis of the algorithmic management of otitis media.

As there was no follow-up symposium this edition loses the element of discussion but it has gained a much needed index. Although expensive and selective this is an important contribution to paediatrics and to medical ethics.