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Doody's Review ServiceReviewer: Mila Ann Aroskar, EdD (University of Minnesota)
Description: This second edition book, a foundation in the history and theory of clinical biomedical ethics, is a presentation of 31 cases. The authors define clinical ethics as "the systematic identification, analysis, and resolution of ethical problems associated with care of specific patients" to distinguish their work from research ethics or more philosophical approaches to professional ethics. Using the cases, the authors pose ethical and legal questions from across the lifespan with responses that integrate and expand on materials from the earlier chapters on history and theory.
Purpose: The purpose is to help clinicians and others, including those in management and administrative positions, respond in a reflective way to ethical issues in a variety of clinical settings. This is a resource for education in clinical ethics.
Audience: The intended audience is all healthcare professionals who grapple with ethical issues in patient care.
Features: In the chapters on history and theory of clinical ethics there is a concise discussion of the context for the practice of clinical ethics and its emergence as an interdisciplinary field within bioethics. The authors give brief attention to questions and concerns in the field. They include who counts as a practitioner in the field, the role of religion and religious beliefs, the role of law, ethics, and cultural competence, the role of public policy, organization ethics, and the business environment of current arrangements for healthcare financing and delivery. Predominant ethical theories and concepts that underlie clinical ethics are presented with a critique of those theories and how perspectives from causistry, caring, and feminist ethics further inform the practice of clinical ethics. Discussions of informed consent/decision making, assessing decisional capacity, futility, and uncertainty are informative for both individuals who are new to clinical ethics and for experienced practitioners. Five broad questions, presented as a "protocol" for clinical ethics interventions, provide a bridge from the more theoretical chapters to the cases. Legal and ethical perspectives are provided on major questions raised by the cases — this is an outstanding feature of this book. A weakness is that the authors purport that this book is for all healthcare professionals, but they fail to draw reference material from the several health professions involved in the practice of clinical ethics. Great strengths include interdisciplinary authorship, excellent overviews of the main features of clinical ethics, ethical and legal discussion of questions that arise in cases from across the life span in a variety of settings, a wealth of references including internet references, and attention to newer ethical dilemmas spawned by advances in medical genetics, HIV medicine, and managed care.
Assessment: This book is highly recommended reading for anyone involved or interested in ethical issues in patient care and decision making.