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A Companion to Bioethics
  1. C Ells

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    Edited by H Kuhse and P Singer. Blackwell, 2001, £18.99 (pb), pp 512. ISBN 0–631–23019–X.

    Bioethics is quickly developing into a vast discipline, with rapidly expanding areas of study and practice, and a rapidly expanding literature. Creating anthologies that provide useful overviews of bioethics is, consequently, a daunting task: many areas important to bioethics must be left out and depth of critical analysis must suffer. The editors of this volume—now in paperback in the Blackwell Companions to Philosophy series—skilfully address these challenges. The result is a comprehensive and authoritative anthology, providing balanced analyses of major debates and trends in bioethics.

    Unlike in most bioethics anthologies, each of the 46 articles in this volume is written specifically for the anthology. The authors comprise an impressive group of international scholars, most with well established expertise in the subjects about which they write. Rather than merely articulating a position and defending it, each author critically surveys a range of ethical understandings or debates on the subject at hand. Consistently, global perspectives, practices, and regulations are reported and an historical context is provided. Yet each article is short (about 10 pages) and accessible to a wide readership. The index and cross references within the articles maximise the value of the anthology as a resource for readers. As well, the references and recommendations for further reading at the end of each article direct readers to excellent resources for more in depth study.

    The anthology begins, in Part I, with the editors’ own historical introduction to bioethics. Part II explores the relationship of bioethics to ethical theory, cultural diversity, gender, religion, and law. Part III surveys various approaches to bioethics (using principles, absolute rules, utilitarian theory, virtue ethics, care ethics, and cases). Unfortunately feminist approaches to bioethics are buried in, and limited to, the article on gender and bioethics. Some non-philosopher readers will be tempted to skip over Parts I–III, and to go to later articles that deal more explicitly with clinical or scientific topics. This would be regrettable, however, as these initial articles (my favourites in the entire collection) provide the general resources needed to clarify and resolve complex ethical problems relevant to any number of specific topics that readers may confront in their work and/or wish to explore.

    Parts IV–VII tackle issues involving embryos and fetuses, reproduction, genetics, and life and death issues respectively. Although they bring clarity to complex issues, taken together, the articles in these sections are the least satisfying because the topics addressed are so well developed in the bioethics literature that the articles seem only to scratch the surface of these complex issues. Nevertheless the novice who has trouble negotiating the vast bioethics literature will appreciate the articles contained here. Perhaps what professional bioethicists will appreciate most in these sections is the article analysing slippery slope arguments.

    Part VIII addresses pressing issues involving resource allocation, some of which are reinforced in Parts IX and X on organ donation and AIDS.

    The global and historical emphasis throughout this anthology is particularly valuable in the articles of Parts XI and XII on experimentation with human subjects and animals. Clinicians and researchers facing ethical and regulatory challenges want to know how local experience compares with experience elsewhere. Some of the concepts discussed regarding human experimentation have been developed further in recent research ethics literature and readers are encouraged to review that broader literature also, to keep abreast of latest developments.

    A series of excellent articles in Part XIII addresses common themes in clinical practice (confidentiality, truth telling, informed consent, capacity). An article on special issues facing nurses, issues often neglected in the literature, is a welcome addition. The anthology ends with Part XIV addressing the role of ethics committees and ethics consultants in health care settings and a critical review of how bioethics is taught.

    For some, this anthology will help to broaden and contextualise their understanding of bioethics; for others, it will be a useful first place to look when confronting particular ethical issues in health care. Health care professionals, clinical ethics committee members, philosophers, journalists, and others will want to read and refer to this book.