On Moral Medicine: Edited by Stephen E Lammers and Allen Verhey

J Med Ethics: first published as 10.1136/jme.26.1.77 on 1 February 2000. Downloaded from Journal of Medical Ethics 2000;26:77–79 Book reviews On Moral Medicine theology had no place for Joseph questions such as respect for life, par- Fletcher’s situation ethics. Indeed, enthood, childlessness, and contracep- Fletcher should be remembered (now tion, his prose becomes dense, his Edited by Stephen E Lammers and that his warm, joyful spirit has passed rhetoric impenetrable. Gustafson Allen Verhey, Grand Rapids, Michi- from us with death) not so much for justly observes that some of his present gan, Wm B Eerdmans, 1998, 1,004 his now faded system as for his having day disciples are similarly entangled. pages, £32.99 (sc), US$49.00. drawn out of Ramsey his Deeds and (Theologians working in medical eth- Rules in Christian Ethics (1965), in ics should not talk to themselves but The sub-title of this book, Theological which Ramsey restored “love” to with medical practitioners). Perspectives in Medical Ethics, is a theological intelligibility. In contrast stands the writing of Chil- more accurate indication of its con- Paul Ramsey stands high in this vol- dress who, no less firm and comprehen- tents than the title. It is a compen- ume, and rightly so. He was at his best sive in theological conviction, can go on dium, an ordered collection of 128 in The Patient as Person (1970), where to ethical implications in such an area reprinted theological and religious he transcribes his covenant theology as technological assessment, cost in writings, grouped in nineteen chapters into the professional relationship be- risk/benefit analysis, and uncertainty in within three major sections - I. Per- tween doctor and patient and the clear, reasoned, analytical prose. spectives on religion and medicine; II. duties they owed in fidelity to one It is a shame, really, that this review Concepts in religion and medicine; another and to society. After that, when has concentrated on a few professing III. Issues in medical ethics. Most he ventured into the new technologies theologians to the neglect of many writers are from the Judaeo-Christian of reproductive medicine and the like, more who, with theology implicit in world; the Christians are from the he seemed to be more inflamed by their minds but not bubbling out of Roman Catholic, Reformed, Protes- journalists and writers of science fic- their mouths, have contributed to the wide range of issues covered in this tant and Anglican (Episcopalian) tra- tion than attentive to what pioneers http://jme.bmj.com/ ditions. Other religions are referred to like R G Edwards and P C Steptoe volume. Modestly pre-eminent among occasionally in passing, and “the were writing and doing. Ramsey could these stands Daniel Callahan, who, in ancient world” is present in quotation shoot down slogans, like “death with the Hastings Center, established a base for continuing collaborative re- and commentary. The volume is a dignity” (he preferred “serenity”); yet flection on issues in medical ethics as, source-book, for reference. Some in his later, more combative writing he in the last thirty years, they have tum- pieces may be read for pleasure; some could deploy the most untheological bled on the scene. His achievement with surprise - how often do we meet slogan of all, “playing God”, so fore- matched, to some extent, by Edward Thomas Sydenham, Florence Night- closing serious attention to dilemmas Shotter’s pioneer work in UK medical ingale and W H Auden among the in neonatal intensive care. Just tributes on September 27, 2021 by guest. Protected copyright. schools and the Institute of Medical “bioethicists”? - some with toil, a duti- are paid to him in this volume. Ethics - should be on record. ful struggle with web-spun words. O’Donovan praises above all his ar- Let the last word be with a physi- Such a tome cannot be summarised in ticulating “the meaning of justice as a cian, as it ought to be. Thomas Syden- review; it can only be commended or feature of the good of society”; and ham (1624-89) writing on what every Thomasma, though he would balance waved away. This reviewer, from the aspirant to the profession should think depths of his native theological tradi- Ramsey’s “covenantal” with “the sac- seriously about, put into twenty lines of tion, can only commend, but only to ramental character of human per- limpid prose the fundamental theology searchers prepared to work hard. sons”, yet admires him for the rigour of which Barth, Rhaner and their/ kind The present phase in moral reason- his ethical thinking, too often lacking laboured for in thousands. Of his four ing in medical practice began, in Eng- in Protestantism. prescriptions the third is this: “... let land, in the 1950s, with theologians Ramsey, O’Donovan and others in him reflect that he has undertaken the and philosophers, notably I T Ramsey, this volume pay their tribute to Karl care of no mean creature, for, in order R M Hare and B S Mitchell, talking Barth, who has dominated Protestant that we may estimate the value, the with doctors working in fields specific theology and ethics in this century. greatness, of the human race, the only to the discussion. There was no The selections from Barth reprinted begotten son of God became himself a confrontation, because of a long tradi- here illustrate his greatness and his man, and thus ennobled it with the tion in British philosophical theology impossibility. He was a master of clar- divine dignity, and, far more than this, of respect for the empirical. In the ity when expounding his basic convic- died to redeem it” (page 145). USA the theological initiative, coming tion, the centrality of Christ and his rather later, was explosive, controver- resurrection. When he tries to apply G R DUNSTAN sial, because Paul Ramsey’s covenant his theological principles to specific Exeter, Devon J Med Ethics: first published as 10.1136/jme.26.1.77 on 1 February 2000. Downloaded from 78 Book reviews Suicide: Right or condemns absolutely from a religious realistic examples may appeal more to perspective, and what he terms instru- our perhaps over-concrete minds. Wrong? (second mental self-killings, which he regards as For my own part, I must leave with edition) more ambiguous. Glenn Graber ex- a confession. I was perplexed to read plores a definition of rational suicide, in the chapter on the Catholic view, a and Joseph Kupfer links an appraisal of quote from St Thomas Aquinas that Edited by John Donnelly, Amherst, the definition of suicide with the next “whoever takes his own life, sins New York, Prometheus Books, 1998, section on its moral interpretation. against God, even as he who kiss (sic) 335 pages, £14.99 sc. Part three: is suicide moral? Is it another’s slave, sins against that slave’s rational? is perhaps less philosophical in master ... .” This curious juxtaposition John Donnelly is a professor of philos- tone. It begins with an article by Edwin of sex and violence provided what I ophy at the University of San Diego in Shneidman taken from the American felt were fascinating avenues for California. This volume is one of a Journal of Nursing, which assumes that speculation on the Catholic mind. It series on contemporary issues of topi- preventing suicide is inherently justi- only gradually dawned on me that it cal public interest ranging, for in- fied, and one by Thomas Szasz on the was merely a misprint. stance, from animal experimentation: ethics of suicide, taking the opposite TIM HELME the moral issues, to sexual harassment: stance. Victor Cosculluela takes a less Consultant Psychogeriatrician confrontation and decisions. There is polar position. Milton Gonsalves elabo- Margate, Kent a separate title in the series on Eutha- rates a traditional theistic position nasia: The Moral Issues edited by the against suicide, whereas David Holley series editors, Robert Baird and Stuart explores and questions the relevance of The Problem of Rosenbaum. This one deals specifi- the metaphor of divine property rights Mental Deficiency: cally with the subject of suicide. in the debate. Richard Brandt adopts a After a comprehensive introduction, utilitarian position, whereas Philip De- Eugenics, Democracy the book is set out in three parts. Part vine argues for the logical opaqueness and Social Policy in one: some historical background con- of death, making utilitarian considera- tains nine chapters with a careful tions unsatisfactory. Joyce Carol Oates Britain, c 1870-1959 selection of contrasting viewpoints, decries the romanticising of suicide in both ancient and modern. Seneca and the arts, denying the notion of death as Mathew Thomson, Oxford, Oxford St Thomas Aquinas, Hume and Kant, liberation. Robert Weir provides a cau- University Press, 1998, 351pages, give way to a more parochially Ameri- tious defence of physician-assisted sui- US$90.00. can perspective in the recent contribu- cide in some cases. This section ends tions. An interview with Jack Kevor- with a discussion of whether suicide is a This book covers an important period kian is balanced by an article by right, with contrasting perceptions by in the development of specialist social, Herbert Hendin, professor of psychia- Leon Kass and Margaret Battin. health and educational services for try and Director of the American The second edition has been up- people with learning disabilities in Foundation for Suicide Prevention. dated and expanded, and contains a Britain. Historically, the term mental http://jme.bmj.com/ There is a chapter by Joseph Fletcher, new appendix with excerpts from the deficiency had wide currency but con- the situation ethicist, and another by Supreme Court’s 1997 decision on temporary synonyms include: mental Celeste Fremon, based on an interview physician-assisted suicide.

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