Reviewer: John K Yost, Ph.D., M.A.,, MDiv.,CCBE. CBE(Bradley University)
Description: The author of this revised dissertation wisely changed terminology from "mental retardation" to "intellectual disability" in concluding research for it. Thus, the book gains value in chapters addressing the ethical and clinical issues of epidemiology, screening, counseling, and prevention. The primary aim of preventing intellectual disabilities (ID), therefore, becomes the question of why prevention, and the answer lies in the future well-being of the person with ID considered in the wider perspective of family and society to face issues of economic impact, family and societal disruption, and the quality of life. What makes this book so valuable has to do with its focus on the beginning rather than the end of life precisely at a time of demographic change in starting families with the perhaps greater risks of ID among children.
Purpose: The book proposes to consider from several different perspectives prevention of actual or potential ID by reflecting upon inextricably related problems of ethics that involve parental autonomy and the role of the medical community. The main aim of this book becomes especially timely in regard to prenatal and genetic matters as well as the role of the principle of autonomy versus societal considerations and the quality of life. The author carefully explores the ethical and clinical issues, yet I imagine he might have wanted to do so at greater length and with more selectivity than a revised dissertation enables him to do. The author provides an excellent synthesis of this timely and urgent topic and the general reader will find it of considerable value, although it reads like a dissertation to an academic. Yet, a revised Finnish dissertation that speaks to real and timely issues that, I believe, captures the interest of a general audience makes this book valuable and worthwhile.
Audience: Student residents, clinical practitioners, medical ethicists, and concerned general readers will be the bulk of the author's audience. The author, a pediatrician and philosopher, has unquestionable credentials for tackling the prevention of intellectual disability.
Features: The treatment of the ethical and clinical issues of the principle of autonomy and the quality of life pertaining to prenatal and later developing intellectually disabilities throughout the book makes this an especially valuable read. And the author recognizes the relative recent and limited treatment of the quality of life issues of interest to me. More discussion of the economic impact would have been important to U.S. readers. And residents, clinicians, practitioners, and ethicists would expect more case studies as a means of wrestling with the issues of this book.
Assessment: A spate of books on the syndrome of autism, and ones related to it, such as Asperger's, published in the past couple of years in England, especially, make this book outdated in particular forms of intellectual disabilities. The author makes no mention of them in this book. Down syndrome receives the most attention, which helps to explain why the dissertation carried "mental retardation" in its title. Hence the author changed the title without giving attention to forms of intellectual disabilities now receiving both technical and media attention. These omissions make the book outdated and necessitate their inclusion in a second edition of this book.
"What makes this book so valuable has to do with its focus on the beginning rather than the end of life precisely at a time of demographic change in starting families with the perhaps greater risks of ID among children." John K. Yost, Bradley University
"The treatment of the ethical and clinical issues of the principle of autonomy and the quality of life pertaining to prenatal and later developing intellectually disabilities throughout the book makes this an especially valuable read." Doody Enterprises Inc.
"PREVENTING INTELLECTUAL DISABILITY is an important contribution to a sparse literature." The Journal of the American Medical Association
"I found it be very readable and thought provoking. The author does an exceptional job of breaking down and defining concepts as they come up, which made it feel quite accessible to someone with a medical and clinical, rather than philosophical, background. In addition to people who work primarily with people with intellectual disabilities, this book would likely be of interest to those who work in child mental health."Nathan P. Somers, M.D., PSYCHIATRIC SERVICES