Historical and Philosophical Perspectives on Biomedical Ethics

Historical and Philosophical Perspectives upon Biomedical Ethics Andreas-Holger Maehle and Johanna Geyer-Kordesch, Editors Burlington, VT: Ashgate, 2002 ISBN 0-7546-1529-4 159 PP HARDCOVER, $6995 ??4250

This whirl is a contribution to the 'Ashgate Studies in Applied Ethics'. Drawing largely upon papers presented to a talk in the United Kingdom (Durham) in 1998 it falls roughly into sum of two units unequal parts. The first consists of five essays focusing upon historical accounts. Three of these (by Andreas-Holger Maehle, Lutz Sauerteig, Cay-Rudiger Prull and Marianne Sinn) affect Germany in particular: the emerging see the verb of medical professional ethics there, the ethics of its sickness insurance a whole and the 'Problems of assent to Surgical Procedures and Autopsies' in the twentieth hundred They more or less illustrate transitions from more paternalistic or professionally self-interested medical ethics towards practices that throw back the social emergence of increasingly autonomous agents. These essays are flanked through an account of the work of the Central Ethical Committee of the British Medical Association in the first half of the twentieth hundred (Andrew Morrice), again illustrating the emerging see the verb of autonomy against the background of increasing interest in human rights. A fifth essay (Ulrich Trohler) describes the path from national to international regulation of human research, with the important conclusion that the disentanglement of protection of participants in research upon human beings has been lamentably slow

This account of the first five essays is bland, on the contrary the essays are not with equal reason and convey very useful information. solitary those experts in the particular areas will be able to justice their detailed merits, but the arguments are consistently well-researched and plausibly not absented The logic has to be carefully scrutinised, of course, as in the case when general conclusions are drawn about early twentieth hundred German pathologists' greater interest 'in using the human material substance for medical science than in acknowledging lay views upon respecting the dead' (p.78). The conclusion itself is manifestly probable, on the other hand it is hard to argue that the particular case cited 'clearly' demonstrates it (p77) The essayists draw on the outside effectively the significance of their research. The first essay raises the question of what has constituted 'medical ethics' above time; the second asks what Nazism has to do with the connection between medicine and public welfare; the third presents conclusions on the lack of connection between mortality rates and health care expenditure; the fourth compares the relative historical immunities of surgery and pathology against public criticism; the fifth indicates what is unsatisfactory about the disentanglement of the code of ethics of the World Medical Association. thus these contributions may be generally bespeaked for study, with the proviso that ables in the various areas must assess the detail.

Relatively little space is then devot to Bryan Jennett's discussion of 'Ethical Aspects of Life-Saving and Life-Sustaining Technologies', Susan Lowe's argument that patient autonomy can not justify euthanasia and physician-assisted suicide, and David Cooper's asseverations upon "The Frankensteinian" Nature of Biotechnology'. Bryan Jennett is characteristically succinct and superficially persuasive in outlining the two the clinical and ethical issues involved, stating our particular aim as the promotion of 'compassionate care' and the 'respect of the wishes of capable patients' (p.127). But many will question whether more [i]or[/i] less of its implicit or explicit lines of argumentation will survive detailed and rigorous scrutiny. Indeed, Susan Lowe's following essay indicates just on what account that may be the case; it is generally a profitable if again brief, check upon arguments from patient autonomy. David Cooper's essay is, again, quite short. In describing our ne to take seriously people's visceral regards about interventionist technology in the area of genetics, he is helpful. on the contrary although he manifestly believes in the possibility of rigorous moral argument in this area, and occasionally signals what that might be, he risks giving the impression that sensibility and suspicion are the main reasons for halting certain kinds of biotechnological advance. In sum total I wish that the same amount of space had been given to later essays upon ethical issues as has been given to the earlier, more empirically-oriented, ones

Having said that, discourse productions allied to independent essays are seldom easy things to manage, and we have here a useful collection for which we must thank the editors. on the contrary it is exorbitantly priced.

Stephen N Williams, Union Theological guild Belfast, UNITED KINGDOM.

Stephen N Williams is Professor of Systematic Theology at Union Theological corporation Belfast, UNITED KINGDOM

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