Diamond, Eugene F.

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The Linacre QuarterlyVolume 43 | Number 1 Article 142-1-1976[Book Review of ] Contemporary Medical Ethics, byJohn F. DedekEugene F. DiamondFollow this and additional works at: https://epublications.marquette.edu/lnqPart of the Ethics and Political Philosophy Commons, and the Medicine and Health SciencesCommonsRecommended CitationDiamond, Eugene F. (1976) "[Book Review of] Contemporary Medical Ethics, by John F. Dedek," The Linacre Quarterly: Vol. 43 : No. 1 ,Article 14.Available at: https://epublications.marquette.edu/lnq/vol43/iss1/14ports that researchers stress sci-entific ability, hard work, and personality as positive traits in a good researcher far more than they stress "ethical concern for research subjects." To the re-searcher, he says, "individual pa-tients are only a means to a much more ambitious end: the attain-ment of that academic recogni-tion which is the reward of the successful researcher. " The book has some errors, however: (1) " Animal studies over the last twenty years have resulted in the discovery that 'aggression' or 'violence' can be understood only in reference to the experimental situation in which it is displayed." (p. 10) Indeed, various organic anomalies have been detected which cause pathologic violence to erupt. (2) On p. 22, in citing the role of an advisory committee on psycho-surgery (at Boston City Hos-pital), he states that the committee has veto power over psychosurgical procedures per-formed by Dr. Vernon Mark. It is my understanding that Dr. Mark has the final word. (3) On p. 76, he refers to the time necessary for tissue culture after amnio-centesis as 7 to 12 weeks. In fact, it is closer to 2 to 4 weeks. Barring these minor errors, the book is a worthy contribution to the list of introductory works on biomedical ethics. There is little armchair philosophy, not much emphasis on futuristics. It is well documen ted, realistic, and pro-vides for interesting reading. As the reader would expect, Restak ends with: "The only real solution .. . the only meaningful bioethic .. . must start by empha-sizing the basically social nature of biomedical technology. In a sense it is a social science." Reviewed by: Paul R. Gastonguay Contemporary Medical Ethics By John F. Dedek (Sheed and Ward, New York. 1975) This book illustrates the unfor-tunate effects of a lack of dialogue between theologians and the Catholic medical community. Fa-ther Dedek has written a book of a very uneven quality because of his isolation from a first-hand knowledge of the practical real-world application of the principles of medical ethics he espouses. As a seasoned teacher of moral theolo-February, 1976 gy at Mundelein Major Seminary in Chicago, he gives lucid descrip-tions of the operation of the Prin-ciple of Tot a lit y in surgical decision-making and of the devel-opment of theological distinctions between ordinary and extraordi-nary means of preserving life. The clarity of these discussions, how-ever, is sadly lacking when he at-tempts to provide practical exam-57 pIes of bedside decision-making. It is interesting to note that t he concept of "therapeutic abor-tion," long ago abandoned by the pro-abortion sector of the medical community, survives as a viable concept mainly in the writings of certain Catholic theologians. In an age when even Planned Par-enthood effectively concedes that abortion does not save anyone's life, Catholic theologians continue to tilt with "therapeutic" wind-mills. Consider, for example, this illustration of so-called therapeu-tic abortion which Dedek quotes from Haring-a gynecologist is operating on a pregnant woman who has a malignant uterine t u-mor. In order to control bleeding uterine varices, he opens the womb to remove the fetus which results in uterine contraction and control of hemorrhage. The uter-us, in this "childless" woman, is thus preserved " undamaged" for future pregnancies. We are not told what happened to the tumor or how a malignancy would have been benefited by this bizarre " therapeutic" procedure. Attor-neys would be interested in this case study as an illustration of classical incompetence or mal-practice but I doubt that anyone would accept it as an example of "therapeutic" abortion. Such examples abound in this book. In the chapter on Homo-sexuality, Dedek condones " physi-cal intimacies with the opposite sex" as a therapy for the homo-sexual. He thus seems to be say-ing that the end justifies the means even if the means is a 58 thoroughly discredited form of psychotherapy. The discussion of an "active response to dying" in the chapter on Euthanasia shows a concern for the societal conse-quences of allowing the patient to commit suicide or t he physi-cian t.o perform direct euthanasia but there is an unwillingness t~ foreclose t.he eventual acceptance of such killing acts. The exposi-tion on formal and material co-operation is excellent but the au-thor is excessively sanguine about t he possibility of punitive conse-quences to a hospital employee following an assertion of consci-entious objection. A careful devel -opment of t he Church's historical position on abortion is followed by an assertion that "contempo-rary theologians" have now " re-turned" to a position where the purposeful destruction of a fetus is allowable when a "proportion-ate value" (the life or the physi-calor mental health of the mother) is at stake. The sources used to support this position demonstrate a rationale strikingly similar to that of Justice Black-mun. The chapter on Contra-ception and S t e r iii z a t ion is noteworthy only for its failure to subscribe to the teachings of Humanae Vitae on these two is-sues. Minor inaccuracies i n d i cat e that the manuscript was appar-antly not adequately proofread by medical experts. The experi-ments of Nobellaureat.es Watson and Crick are incorrectly identi-fied and the application of the Primum Non Nocere principle in Linacre Quarterly medical practice is incompletely understood. The blurb on t he jacket ad-dresses the book to "doctors and nurses in training" and "hospita l and medical school libraries." The $7.95 cost of t he hardcover vol-ume could be much better spent on a more authoritative work on medical ethics . Reviewed by: Eugene F. Diamond, M.D. Stritch School of Medicine The Courage To Fail: A Social View of Organ Transplants and Dialysis By Renee C. Fox and Judith P. Swazey (Chicago: Universi ty 0/ Chicago Press . 1974) In this engrossing, informative, and richly documented work a sociologist (Fox) and an historian of science (Swazey) have teamed to give readers an exceptionally thoughtful and intelligen t ac-count of t he social, ethical, and existential questions that are posed by recent developments in medical science. They focus at tention on two specific types of medical proce-dures: t he transplantation of hearts and kidneys and the use of hemodialysis for t he treatment of patients suffering from irrever-sible kidney fai lure. Following a case history approach, t hey ex-amine in great detail such prob-lems as the "gift-exchange" di-mensions in both transplan tation and organ donat ion , the "gate-keeping" role of the physician in determining who is to give and who is to receive, the ethics of experimen tation on human sub-jects, and t he criteria for t he al-location of sparse m e d i c a I resources. Throughout, their con-cern is to highlight the broader February, 1976 social, cul t ural, and ethical di-mensions of medical research in-volving human subjects. The chapter dealing with gift exchange and the ga tekeeping function of the physician is par-t icularly illuminating for showing how organ t ransplantation and hemodialysis place the donor (or admi nistrator of hemodialysis) and donee in a human situation in which they can become related to one another either in a wonder-full y t ranscendent way or in ty-rannical bondage. H ere the physi-cian 's key role is to screen poten-tial donors and recipients not only biologically but psychologically and sociologically as well so as to minimize t he possibility of plac-ing human beings into in tolerable and dehumanizing bondage to one another. In many of the chapters, and particularly in those concerned with the development of heart transplants and with the famous "case of the totally artificial heart" involving t he noted heart surgeon, Denton Cooley, t he prin-59 

[Book Review of] \u3cem\u3eContemporary Medical Ethics\u3c/em\u3e, by John F. Dedek

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[Book Review of] \u3cem\u3eContemporary Medical Ethics\u3c/em\u3e, by John F. Dedek

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