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Australian lawyer Russell Scott provides both a global and a historical perspective in this considered analysis of the medico-legal issues concerning organ transplants, artificial insemination, in vitro fertilization, and other high-tech achievements of medicine and surgery. As Commissioner-in-charge of an Australian government task force to develop a model code of laws, he has reviewed cases, legislation, and uniform codes developed over the years in the West, and elsewhere. (Included are engrossing/macabre accounts of the body-snatchers, as well as other vignettes of history or anthromorphology.) Americans may not be surprised to hear that many issues in this country remain muddled in ""confusion, diversity, inadequacy,"" with state-by-state differences or court-imposed ad hoc decisions. A Uniform Anatomic Gift Act was adopted by all 50 states in the early '70s, governing the rights to donate tissue after death. The act has been criticized for omitting discussion of payments and for establishing priorities that begin with the government's right to conduct legally-required autopsies--and only end with the needs of the sick or dying ""donees."" European trends are toward increasing government control over the disposal of tissue, but commerce (payment) is strictly forbidden; in America, contrastingly, there are no laws prohibiting the sale of blood, semen, or even a kidney. Clearly, major issues must be resolved, and to Scott's credit he does not urge a rush to legislation but a more seasoned approach based on accumulating experience. Personal autonomy would be a paramount principle (one infers, therefore, that he would affirm a woman's right to abortion). Concluding, he discusses the Australian model and his ideas for a further expansion into laws--with provisions for living versus dead tissue; regenerative (blood) versus nonregenerative tissue (kidney); minor and incompetent donors versus adults in sound mind. For living donors, free and informed consent would be essential. After death, Scott veers toward a policy of ""contracting out""--allowing the government to intervene unless the deceased had specifically stated that the body was not to be used. Part and parcel of his philosophy is the need to educate the public concerning the issues and the life-saving value of human tissue. His book underscores that point in prose that is informed and sophisticated, but never so legalistic as to lose the reader.

Pub Date: July 1st, 1981
Publisher: Viking