DOCTORS' DILEMMAS: Moral Conflict and Medical Care by Samuel Gorovitz

DOCTORS' DILEMMAS: Moral Conflict and Medical Care

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Gorovitz is a philosopher (U. of Maryland), and his point of view on medical bioethics is refreshingly unlegalistic and undoctrinaire. He questions; he reasons; he introduces historical perspectives. Here, then, is medical ethics with commentaries from Plato, Aristotle, Kant, Bentham, and Mill; also, John Rawls (A Theory of Justice) and Robert Nozick (Anarchy, State and Utopia). The result, often, is lively discourse, informed opinion, and the espousal of arguments that, if they do not resolve differences, could at least get right-to-lifers talking to abortion defenders. Essentially, the method is Socratic, and Gorovitz goes so far as to present dialogues presided over by wise interlocutors. At such times, the hand is too heavy (as it is elsewhere when Gorovitz over-amplifies). For the most part, however, the philosopher's voice is clear and reasonable. Gorovitz is particularly to be commended for not dismissing the minor failings of doctors--their paternalism, impatience, arrogance, failure to apologize for waiting time. He points out that neither behavior nor interpersonal relations is taught in medical school. Indeed, part of his prescription for better professional-patient relations would be the inclusion of some courses on ethical issues in the curriculum, as well as ensuring that a medical student spent some time as an in-hospital patient. On the larger issues of letting-die, in vitro fertilization, surrogate mothers, and abortion, Gorovitz does not opine What-Is-Right so much as he refines, defines, and shapes the issues to point toward a proper course of action. Case studies are introduced appropriately--and, in one instance, tellingly: a class, having split on the issue of letting a hopelessly brain-damaged child die, sees the child in the hospital. Emotion had never entered into their arguments. Chapters on setting public policy and on being-a-good-doctor are helpful additions--the one discussing the need for some sort of collective wisdom to guide decision-making, the other containing Gorovitz's ideas on reforms in medical education. They alone should stir debate and add to the value of the volume.

Pub Date: Aug. 1st, 1982
Publisher: Macmillan