REVIEWED BY JOHN E. MORLEY, MB, BCh
Mathy D. Mezey, Christine K. Cassel, Melissa M. Bottrell, Kathryn Hyer,
Judith L. Howe, and Terry T. Fulmer, eds.
Johns Hopkins University Press, Baltimore, 2002, 354 pp., $24.95 (paperback)
This is a very readable book on ways in which interdisciplinary teams can interact
efficiently. The authors offer excellent comments on how to resolve conflicts
between team members. Case studies give wonderful examples of how team members
can resolve difficult problems faced by older persons.
My problems with the book have to do with its claim that it will provide a
greater understanding of ethical principles involved in the health care of older
persons. It sometimes appears that our world is becoming filled with self-proclaimed
health care ethicists. Unfortunately, many of these people lack appropriate
training in the rigors of ethical practice and logic. Their ethical advice is
based on their opinions rather than on a carefully considered ethical argument
and an examination of the history of ethical and judicial opinions in the area
under consideration.
Another area in which ethicists fail to make clear statements is that in which
ethical judgments are overlapped by spiritual or religious beliefs. In many
areas of health care, ethical issues are grounded in religious belief. This
is clearly appropriate, but it is important that the ethicist makes his or her
rationale for ethical belief clear.
The ethical decisions offered in this book, although they often appear to be
appropriate, come unaccompanied by a rigorous ethical understanding of why they
are appropriate. In some cases, a different religious belief could clearly have
resulted in a different ethically appropriate outcome.
I strongly recommend this book to those who wish to learn more about how to
create highly functional interdisciplinary teams. On the other hand, those who
wish to learn from it more about ethical approaches to the care of older persons
will most probably be disappointed.
John E. Morley, MB, BCh
Professor of Internal Medicine
Department of Geriatrics
Saint Louis University School of Medicine,
St. Louis