Principles of Biomedical Ethics

Tom Beauchamp, of Georgetown University, and James Childress, of the University of Virginia, have produced a splendid sixth edition of their classic book on biomedical ethics. Throughout, the authors sensitively discuss real life dilemmas. Part 1 looks at moral foundations: moral norms, moral character and moral status. Part 2 studies what the authors define as the four key moral principles, general norms of our common morality: respect for autonomy, doing no harm, beneficence and justice. Part 3 examines moral theories and moral justification. They argue that there is not just one supreme moral value, a single absolute yardstick to solve every ethical problem. They write, "The problems of bioethics are often problems of getting just the right specification or balance of principles. Principles should never be conceived as trumps that allow them alone to determine a right outcome. ... rights, like all principles and rules of obligation, are prima facie (i.e., presumptively) valid claims that sometimes must yield to other claims." To aid our moral deliberation and decision-making, we need to consider our actions or inactions in regard to dilemmas in the light of each of the principles. "Principles need to be made specific for cases, and case analysis needs illumination from general principles." Putting the four principles of bioethics into practice results in moral behaviour. The authors argue that respect for autonomy is not necessarily individualistic, rationalist or legalistic. With beneficence, we must take responsibility for our community, competently, compassionately and cooperatively. The authors argue that justice entails that governments fund health care, as our collective social protection against threats to health. Justice (fairness and equity) and utility (efficiency) are essential to health care systems. They sum up, "Policies of just access to health care, strategies of efficiency in health care institutions, and global needs for the reduction of health-impairing conditions dwarf in social importance every other issue considered in this book. ... we have proposed that society recognize global rights to health and enforceable rights to a decent minimum of health care within a framework of allocation that incorporates both utilitarian and egalitarian standards."

This book is a classic book for those who`s study the principles of bioethics, because Beauchamp and Childress shows what they think in terms of good medicine and good practice

Having used this volume and its previous editions for over 20 years, the latest edition provides an easier read for those not steeped in traditional, philosophical writing. While emphasizing the importance of the blended principled approach to bioethics (autonomy, non-maleficence, beneficience, justice) the authors in this latest edition invite the reader to a deeper appreciation of the widening diveristy in ethical approaches, including such approaches as the ethics of care. An important read as well as a practical tool for leaders who seek to sharpen their thinking abilities and broaden their knowledge base in the area of health care. Dr. James Wells, NHA, D.Min Senior Living Institute 13 Roszel Rd. C120 Princeton, NJ 08540

Very useful for anyone interested in Bioethics. Well written and comprehensive.

Book Review PRINCIPLES OF BIOMEDICAL ETHICS Tom L. Beauchamnp and James F. Childress"You can't tell a book by it's cover." Don't you believe it! Principles of Biomedical Ethics by Beauchamp and Childress is every bit as formidable as it's cover might suggest. That is not to say that the book is poorly written or inadequate in any way. It is just that this reviewer is a student, whose professor, at the end of the course confessed to the class the the text was indeed a demanding work requiring proportional effort on the part of the student. Granting that, it was the best of several texts he had examined.After setting the stage, in chapter one with a discussion of approaches to ethics, the authors, in chapter two, deliniate in detail, eight classical ethical theories, which form the foundation of the study. Through liberal use of examples, the authors reveal that all theories have both weaknesses as well as strengths and that to rely on one theory to the exclusion of others is indeed a hightly questionable approach to ethical decision making. In the subsequent six chapters, the authors continue with a wealth of case studies, elaborate on the importance of autonomy, privacy and dangers of paternalism; they discuss the elements of nonmaleficence and beneficence as essential elements in the Hippocratic oath. Distictions are made between killing and letting die. Arguments are made for and against the use of medically administered nutrition and hydration. Balancing prima facie norms to provide treatment and for truth telling are examined and the extenuating circumstances when these seemingly basic tenets may not be appropriate are discussed.The authors have not dodged the knotty problems of availability of organs for transplantation, rationing of scarce treatments and health care resources, costs of health care or the concepts or theories of justice as they relate to health care. The appendix consists of ten case histories. There is a abundance of footnotes at the end of each chapter sufficient to satisfy the most rigorous student.This is not a book for the casual reader. But for someone desiring an in depth treatment of current issues in health care from the standpoint of the physician, chaplain or health care administrator, I recommend this book without reservation. Ernest G. Barr