Abstract
This book is a library. It is a substantial library, but an incomplete one. The attempt to combine, and even to integrate the two fields was innovative in the first edition and remains bold in the second, particularly when the work is directed to all of the health professionals. The six introductory chapters remain an outstanding primer in both realms, and set the thoughtful tone of the remainder, for the book works as a stimulus to thought, rather than being a simple compendium of potted Law, or an expanded Code of Ethics. The seeker after a quick reference to, say, competence to make a valid will, will find matters to consider in place of a simple summary of case law. Even in the ‘boxes’ where simple souls might be accustomed to finding tabulated advice, they will find that thought and judgement are expected. Because of this, the book provides an excellent basis for teaching. The language and law is up to the minute, the ancients among us will find no mention of such a rubbery concept as ‘clinical responsibility’, but much on the elastic notion of ‘duty of care’, reflecting the overall shift from a received view of professionalism to a pervasive legalism. The book is in general an excellent guide to the world we are being forced to enter.
Inter-professional issues require further discussion; they are well covered in relation to nursing, where one of the authors is amphibious, and an open attitude is shown towards ‘complimentary and alternative medicine’, but it would be timely to have a chapter on interfaces with such fields as social work, which does not receive a mention. The chapter on the pharmaceutical industry, an important preoccupation of another of the authors, is concise and excellent. It provides, on page 592, one of the few mentions of New Zealand; another important one concerns the innovative concept of ‘medical misadventure’ developed there in place of negligence.
Ethics are the same on both sides of the Tasman Sea, law a little different, although both nations are part of the Common Law world. The chapter on indigenous issues is entirely confined to Australia, and might have bene- fited from a discussion of the contrasting situations among Maori and Pacific Island people.
Adherence to broad principle still permitted a chapter on matters peculiar to ‘people with mental illness’, and psychiatry finds much of its place there. The problems of the aged are also treated as a special topic, but concerns such as those surrounding mental handicap must be sought under the separate issues involved. The ethical and legal problems that loom so large to psychiatrists are mostly embedded somewhere in the tome, but a discussion of criminality is mainly to do with the professional as criminal, not the patient. However, a very full reading list is provided. The title makes a very broad claim which the book does not totally fulfil. The book cannot displace Bloch, Chodoff and Green (Psychiatric Ethics) from our shelves, nor should we lightly discard ancient textbooks of medical jurisprudence, even Dix, Errington, Nicholson and Powe (Law for the Medical Profession). It is a marvellous treatise on cooking, but most of us still need the recipes as well.