REVIEWED BY CARL MIDDLETON, PhD
Ethics for Everyone: A Practical Guide to Interdisciplinary Biomedical Ethics Education
Linda C. Grafius, EdD
American Hospital Publishing, Inc., Chicago
1995, 288 pp., $61 (paperback), $49 (AHA members)
Ethics for Everyone is a well-written, substantive book that can be used to educate biomedical ethics committees. The author is obviously well versed in the overall functioning of ethics committees.
The book's eight chapters are basically divided into three sections: an introduction to biomedical ethics, a discussion of the various issues and topics in the field, and a guide to useful educational tools.
Chapters one and two describe the history of the biomedical ethics committee, its contemporary role and function, and the role of committee members. These chapters also offer advice on the orientation of committee members. And they urge healthcare organizations to educate not only committee members but all other employees as well.
Chapter three first gives an overview of the history of biomedical ethics and then introduces some of the field's most significant topics. These topics, most of which the typical biomedical ethics committee will eventually have to respond to, include informed consent, advance directives, medical futility, the right to die, euthanasia, and physician-assisted suicide, to name but a few.
Chapter four describes a process for ethical thinking and reflection. The process consists of six basic steps: gathering the facts, developing an understanding of the ethical issues involved, clarifying the patient's perspective, identifying the treatment alternatives, determining the best interests of all involved parties, and selecting the most appropriate treatment alternative.
Any healthcare organization would benefit from developing a model of ethical thinking that reflects its values, the author argues. "By establishing a standardized process for ethical thinking and reflection, an institution provides a framework for case analysis that is clear, logical, comprehensive, and easily documented," she writes. Chapter four will be especially useful to biomedical ethics committees, particularly those in a formative stage of development.
Chapter five makes what may be a unique contribution to the literature--a detailed, step-by-step guide to developing and implementing a biomedical ethics grand rounds program. This chapter's samples and illustrations should be of great benefit to the reader. Grand rounds can be excellent educational experiences because they often clarify ethical issues, not just for biomedical ethics committee members but for the entire staff.
Chapters six, seven, and eight provide various tools that can be employed in ethics education, directions for the tools' use, and copies of handouts required for the exercises. The author gives readers permission to copy these tools and handouts.
Ethics for Everyone also contains an excellent, up-to-date bibliography; a list of resources; a glossary; and an appendix describing a grand rounds program for noncompliant patients.
Although the book is well written, informative, and very useful, it does suffer from one omission. Like other literature aimed at bioethics committee members, Ethics for Everyone lacks an introduction to the basic principles of ethics and social justice, written in clear and understandable language for those who lack an in-depth philosophical background.
However, this shortcoming does not keep the book from being useful for those who have responsibility for the orientation, formation, and continuing education of biomedical ethics committee members and other healthcare workers as they try to understand and respond to complex ethical issues in our society.
Carl Middleton
Vice President, Ethics and Leadership Development
Sisters of Charity of Nazareth Health System
Louisville, KY
Copyright © 1997 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.