What makes for a good book on ethics in medicine? Given that no one can do another’s moral thinking for them, this much at least: it should stimulate in the reader an inclination to critical reflection that will persist when the book goes back on the shelf. And, since no one can do another’s philosophical thinking for them either, this requirement is doubly true when the basis of the work lies in moral philosophy. In addition, where the book is likely to be used as an introduction, it has to achieve this for readers who may have little experience of philosophy or natural sympathy with its problems and methods. No doubt there are various ways of attempting this task, but one is to try to draw readers into the subject by giving them a sense of what it is to be involved in doing philosophy, with all its characteristic difficulties and doubts, rather than merely studying the results of some that was done earlier. I think that Jennifer Jackson has produced an excellent book of this kind; one that should engage the interest of anyone prepared to make a little effort. It is a lively and refreshing work, full of argument and comprising a good mixture of scholarly caution and forthright commitment. Rather than looking at the many specific issues, however, I will concentrate on the philosophical position that underlies the work as a whole.

The book begins by taking seriously the doubts that exist about the place of philosophy in medical ethics and does particularly well in making the appropriate concessions, while still giving a firm defence of its …