On-line version ISSN 2078-5135
SAMJ, S. Afr. med. j. vol.101 n.4 Cape Town Apr. 2011
Medical ethics, law and human rights. A South African perspective
Edited by Keymanthri Moodley. Pp. xx + 377. R369.95. Van Schaik Publishers. 2011.
Issues related to ethics, law and human rights enter into the everyday work of medicine and the health sciences. Almost daily we encounter scenarios that raise ethical concerns - from laboratory work on stored human tissue, interactions between health care providers and patients, to the shape of policies and programmes to deliver services to populations. Yet, most health care providers and managers have had little formal training in ethics, law and human rights. As a result, most deal with ethical concerns with little preparation, or, worse, fail altogether to recognise the potential implications of their work.
This edited volume fills a critical role by introducing a comprehensive and practical approach to the kinds of ethical, legal and human rights issues that doctors and other health care providers may encounter on a daily basis. The authors are drawn from South Africa's leading experts in this field. Significantly, most of the authors are clinicians who have gone on to study and work in bioethics - ensuring that the content is both theoretically sound and imminently practical.
The book is divided into two sections. The first introduces key concepts in ethics, law and human rights (including surprisingly easy-to-read chapters on the philosophical basis for modern bioethics). Chapters in the second section discuss the ethical concerns that arise in different areas of clinical practice, such as paediatrics, mental health, end-of-life care, genetics, HIV/AIDS and organ transplantation. Of particular value is a chapter presenting a framework for decision making when faced with ethical dilemmas. Although there are comprehensive chapters on research ethics and global health, this work is focused squarely on issues of health care provision in the South African context.
This volume appears targeted at introductory and mid-level audiences. The material is presented in a well-organised and easy-to-follow format; potentially difficult content is presented in an approachable (and at times entertaining) style. Concepts and issues are carefully explained, with examples and case studies - most of which are drawn from South Africa - used to demonstrate how theories can play out in the real world. In most chapters these case studies are followed by several questions to the reader, and then a commentary explores different approaches to answering the discussion questions.
Overall, the presentation is clear enough to be digested by undergraduate students, but the content and format will appeal greatly to clinicians and managers working in services. More generally, this volume provides an invaluable starting place for any health professional who has faced a potential ethical challenge and not known quite what to do.
Landon Myer, MA, MPhil, MB ChB, PhD
School of Public Health and Family Medicine
University of Cape Town