Ward Ethics: Dilemmas for Medical Students and Doctors in Training

By Fergusson, Andrew | Ethics & Medicine, Fall 2002 | Go to article overview

Ward Ethics: Dilemmas for Medical Students and Doctors in Training


Fergusson, Andrew, Ethics & Medicine


Ward Ethics: Dilemmas for Medical Students and Doctors in Training Thomasine K. Kushner and David C. Thomasma, Editors Cambridge: Cambridge University Press, 2001 ISBN 0-521-66452-7, 265 pp., paperback, $30.00

Those of us who have followed medical ethics for a decade or two probably accept the recent division into `Bioethics 1', covering for example the older issues of abortion and euthanasia, and `Bioethics 2'-pre-implantation genetic diagnosis, cloning, nanotechnology, etc. But there is a third category of health care ethics which particularly interests current and former clinicians like me-the ethics of everyday practice, the ethics of the clinical world, or, as the editors of this collection of cases and commentaries have termed them: `Ward ethics'.

Thomasine Kushner and David Thomasma are also co-editors of The Cambridge Quarterly of Health Care Ethics. They have compiled a series of more than 80 case studies from around the world and invited leading ethicists and clinicians to comment on them. They felt the need to do this after years of listening to medical students and trainee doctors and have, according to the blurb, produced 'an essential guide to coping with the ethical dilemmas of those embarking on their medical careers.

But have they? In the first place, this book is marketed worldwide but is heavily dominated by examples and comments from the U.S. Of the 46 invited commentators, 33 are from the U.S. The others are from Argentina (1), Canada (2), Denmark (1), England (2), France (1), Israel (1), Italy (1), Japan (1), and The Netherlands (3). Although the case studies sometimes suggest a country of origin it is not usually possible to be certain, but a similar proportion of the cases seem to be from the U.S. While the fundamental principles of the ethical dilemmas in question apply anywhere, the precise problems are very culture-specific, and U.S. medical culture is very different from European medical culture. So much so, there has to be a glossary translating U.S. terms for us Europeans!

My second reason for suggesting that this book is not best aimed at `those embarking on their medical careers' is that it is a heavy read. Although often human and even humorous, it is also an academic work, using the precise (and therefore cumbersome) language of social scientists and professional ethicists. In short, for students and doctors in training the book could have been a lot shorter.

But I think this book is excellent, so for whom do I recommend it? …

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