Well and Good: Case Studies in Biomedical Ethics (review)

BOOK REVIEW Well and Good: Case Studies in Biomedical Ethics. ByJohn E. Thomas and Wilfred J. Waluchow. Lewiston, N.Y.: Broadview Press, 1987. Pp. 192. $10.95. Well and Good, a casebook of biomedical ethics, is an easy introduction to several ethical theories and to ethical problems, common and esoteric, that have emerged in the era of technologic medicine. The authors, John E. Thomas and Wilfrid J. Waluchow, both professors of philosophy at McMaster University, begin with a brief and lucid introduction to the moral philosophies of Immanuel Kant, J. S. Mill, and W. D. Ross, then move to the case histories that serve to illustrate a range of topics in medical ethics. These topics include ones that have been the subject of popular debate, such as abortion, prenatal screening, nontreatment of "handicapped" newborns, medical involvement in human reproduction, and experimentation with human subjects. The case studies also illustrate topics less subject to public scrutiny but more likely encountered in the day-to-day practice of medicine. These include the process of informed consent, the patient's right to refuse treatment, discontinuing life-sustaining treatment, and brain death. But these represent only a small sampling of the difficult ethical decisions one commonly encounters in clinical medicine. Since the authors are from a country with a national health service, American readers will not find case studies reflecting the ethical problems associated with unequal access to health care. In their discussions of the cases, the authors do not offer counsel about how one might ethically resolve dilemmas; nor do they propose potential solutions one might derive from the ethical theories they have presented. The authors are content to point out value conflicts and key distinctions through asking questions , leaving the reader to apply the theory or simply ponder the answers. Well and Good, then, does not so much serve as a guide to making better decisions but as a stimulus to explore, preferably with others, the complex ethical dilemmas that are part and parcel of modern technologic medicine. The reader need not have any specialized medical knowledge or any background in analytic moral philosophy to enjoy reading this book. It is clearly written and seems well suited as an introductory text on which to base small group discussions of poignant problems in medical ethics. Robert M. Walker Department of Medicine Centerfor Clinical Medical Ethics University of Chicago Permission to reprint a book review printed in this section may be obtained only from the author. 466 Book Review ...