REVIEWED BY SR. JULIANA CASEY, IH, STD, PhD
The Right Thing: Ten Years of Ethics
Columns from the Healthcare Forum Journal
Emily Friedman
Jossey-Bass Publishers, San Francisco
1996, 416 pp., $29.95
The Hebrew scriptures contain evidence that people became very nervous when there were no prophets in the land. The absence of prophets meant that God had stopped speaking to the people and had left them to deal with life on their own--a frightening prospect.
I was reminded of this as I read The Right Thing: Ten Years of Ethics Columns from the Healthcare Forum Journal. Nowhere in this collection of columns does Friedman claim to be a prophet. She does not claim to speak for God. Nonetheless, those of us who read her columns have a strong suspicion that she is, indeed, a prophet in the troubled land of healthcare.
The Right Thing includes almost every column that Friedman has written in 10 years at Healthcare Forum Journal. Her subjects cover a wide range, including Canadian medicine, Australian healthcare, managed care, and the goodness of those who work in healthcare. Friedman is keenly aware of what is happening in her field, and she is conscious of the significance and the implications of both events and trends.
Friedman's column is not primarily about events, facts, or figures, however. Her columns provide us with an interpretation of these things. And this is the book's great value. As Friedman considers the issues, she provides interpretations that are real and meaningful.
Friedman's writing is crystal clear. Her presentation of complex and emotionally charged issues enables the reader to understand those issues as well as the ramifications of the various positions on them. Friedman recognizes system trends as well as social ethos that influence the interpretation of healthcare issues. For example, in a column titled "Above the Law," Friedman writes, "We are a nation of mavericks, dedicated to individual liberty, and none of us likes to confront the specter of constraint."
One learns from reading these columns. Friedman elucidates principles and teaches lessons. In "Concept of Community," she asks, "What is a community?" She then describes different types of communities and the benefits and inadequacies of each. It would be well for all of us in the healthcare field to reread this column before next discussing how we will improve the health of our communities.
It is not only Friedman's vast knowledge or the clarity of her perceptions that make this book a valuable resource. It is, finally, Friedman's passion. Her columns are not detached analyses of abstract issues and rational positions. They are the intelligent writings of an expert in the field of healthcare in the United States who cares deeply about that field and the people who serve in and are served by it. Whether she writes about the more than 700 deaths in Chicago's 1995 summer heat or society's responses to AIDS, Friedman does not forget the people who are involved, who suffer, or who die. Her columns frequently make plain what many of us would rather not see. Sometimes the reader wishes that Friedman were a little less involved, a little more dispassionate. But this is the reader's desire for ease, not the writer's shortcoming.
Although this book may trouble us, it also gives us hope. We can clarify muddled issues. We can work together and find solutions. We are not alone in this troubling world--we have each other. It is this last fact which finally consoles the reader. If there is one conviction that echoes in every column, it is that we are in this together. To remember this is our challenge, and our opportunity. As Friedman tells us, "We can certainly keep in the back of our minds that we have this singular opportunity--to answer helplessness with goodness--and that few others are so graced."
We can all take a deep breath. There are prophets in the land.
Sr. Juliana Casey, IHM
Vice President, Mission Services
Sisters of Mercy Health System
St. Louis