Edited by John Kilner, Robert Orr and Judith Shelley, Michigan, Wm B Eerdmans Publishing Co and Cumbria, Paternoster Press, 1998, 314 pages, US$19.00.

In the words of the editors, this book is “an honest attempt to grapple with the often-conflicting matters involved in the changing face of health care” (page xii). This “changing face” refers specifically here to the American style of managed care. However, by implication it also applies to other health care systems where resources are being rationed and schemes have been in put in place to achieve this end.

Managed care has received much criticism, mainly from those health care practitioners who work at the coalface. Managed care has changed the face of health care because it restricts the autonomous practice of physicians to acting in what they …