On Moral Medicine - Theological Perspectives in Medical Ethics

Stephen E Lammers and Allen Verhey (eds)
Eerdmans 1987/repr 1989 ISBN 0-8028-3629-1

Reviewed by:

Bruce C Wearne
Department of Anthropology and Sociology
Monash University

This is an encyclopaedic anthology concerned with medicine and ethics. It was published against the background of contemporary developments in medical technology but the editors have considered that such a reader will have a ready market in a variety of professional fields, including the training of church office-bearers. It is a course-book for double Masters degrees in Medicine and related fields like nursing and theology.

The editors are also aware that there is a need for informed ethical reflection within the context of medicine, medical training, nursing and nurse education. The book comprises 105 different entries, in three parts - Religion and Medicine; Concepts in Religion and Medicine; Issues in Medical Ethics. The work is a thoughtful compilation and a rich resource. Among Christians there is much concern about how to offer advice about medical ethics to those who are training to be professionals in health-care. Many still enter nursing out of deeply held vocational convictions. The ethical contours of a person's professional development is often ironed out in ethics course by flat, utilitarian and economic rationalist argument posing as the `bottom line' in ethical discussion.

This anthology does not pretend to offer ready answers to all the vexing problems which face us; but it does provide a variety of perspectives on the variety of problems which should not be glossed over with yet another generation of spiritualistic (power) rhetoric or materialistic reduction. Professional people in the health professions, scientific researchers and others who wish to develop an historically-rich perspective on medical and nursing ethics will find much to chew on here.

Two critical points :

1. nurses and nurse educators should not be dissuaded from obtaining this book just because of its resort to the term medicine, and its apparent accomodation to the ideology of medical dominance. Moral Medicine may well try to be a first step to a Christian perspective in health-care but it actually side-steps the necessary task of re-defining medicine as an advanced and technically developed form of nursing. If a Christian perspective in this arena is to be developed, with at least more than passing interest in what the Great Rabbi said about great power of service (Matthew 20:20-28), then we will need to avoid viewing nursing as an inferior and ancilliary service to the medical profession's dominance. Rather a Christian approach has a ready-given basis from which to view medicine as a specialised form of nursing (service).

This volume does not sufficiently address the development of the nursing profession and the significance of such for our appreciation of medical ethics. The anthology gives some attention to the ethical question of care which is central to a nursing professional philosophy, but the question of care is not addressed as a social structural issue in health-care provision.

2. A second critical point concerns historical and sociological omissions. There is no sustained discussion of the contribution of Islam and other non-western medicine. The contribution of such views to ethical debate about matters of life, health and death should not be ignored. This omission is obviously due to the editors emphasis upon what Christians have written, and what American Christians in health-care professions might want to re-discover, but this should not lead us to misrepresent the historical development of medicine.

Moreover, an updated version should include sociological consideration of the structure of hospitals and the societal contribution of such as a "hotel of care".

Those who have no Christian or other religious profession that they know of will still find much to think about in this encyclopaedic book.

Volume 2 - No. 1