Eds Kenneth Kearon, Fergus O'Ferrall
Columba Press, £7.99, pp 160
ISBN 1 85607 269 X
Rating: 2/4

This wide ranging compilation of lectures, hosted by the Adelaide Hospital Society in Dublin in 1999, kicks off with a great overview of the current state of medical ethics. This sets the stage for an edited text that is meant to provide the lay reader with a basic introduction to medical ethics. Unfortunately, the varied chapters fall victim to discontinuity, reducing this work to an insufficient reference resource.

The book does cover some of the basics of ethics, such as patient autonomy and consent. Cusack argues that the increase in litigation by patients reflects a movement towards autonomy, as medical providers are increasingly scrutinised by empowered patients. Webb follows by reviewing the subject of ethics as applied to psychology and psychiatry and concludes that psychiatrists still wield considerable power over patients. Hanafin discusses whether the right to die should be covered by legislation, criticising Irish society for its inability to address the issue properly and for failing to consult lay people.

One successful chapter, by Walter Prendiville, examines contemporary ethical issues relating to women's health. Reproduction has implications not just for parents but for doctors and the broader society. Prendiville discusses the ethical and religious issues raised by contraception and the moral implications of abortion. "Holistic medicine" has its own set of ethical dilemmas, argues Verena Tschudin, who also challenges the current definition of this popular phenomenon. The author argues that ideal medical care requires an open minded doctor willing to consider all forms of treatment and devoted to increased patient participation in treatment.

If you thought that globalisation has increased accessibility to medical resources you'd be wrong. Marianne Arndt argues that the ongoing existence of inequity means that "care" is an illusion and that health hinges less on medical advances than on creative, cooperative planning between governments and health professionals.

Sheila Greene looks at genetics and the future of humanity, discussing the potential benefits and perils of a technology that can lead to a "commodification of human beings." She sorts out the questions and concerns that all doctors will be considering for years to come.

Given the existing international literature on medical ethics, Medical Ethics and the Future of Healthcare is a parochial work, and it reads like an incongruous series of confer. ence lectures. It is just about redeemed by its brilliant opening overview and its fascinating assessment of arguably the most contentious medical issue today - the moral implications of genetics research.