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Robert Veatch, director of the Kennedy Institute of Ethics, professor of medical ethics at Georgetown University, author of The Patient-Physician Relation (Indiana University Press, 1991).

According to Veatch, the explosive growth of the field of medical ethics has made it ever more specialized, but "the definitive survey is Principles of Biomedical Ethics, by Tom Beauchamp and James Childress (Oxford University Press, fourth edition, 1994)." Meanwhile, Deciding for Others: The Ethics of Surrogate Decisionmaking, by Allen Buchanan and Dan Brock (Cambridge University Press, 1990), is "the authoritative treatment [of] the hot issue of our period," says Veatch. "This book has probably advanced discussion of the subject ofsurrogate decisionmaking more than anything else written. It sorts out at great length, for instance, the difference between a surrogate making decisions based on the patient's values and a surrogate deciding on the basis of his own values. It deals with great sophistication with complicated problems, like whether the patient's values remain relevant alter he's lost so much mental capacity that he no longer remembers who he was."

John Lantos, associate director of the Center for Clinical Medical Ethics at the University of Chicago.

"Probably the most common situation ethicists are consulted about has to do with adult children making decisions about their dying parents," says Lantos. "We find that people have no idea what's expected of them in those situations. Patrimony: A True Story (Vintage, reprint, 1996), novelist Philip Roth's account of his father's protracted death from a brain tumor, is an exploration of what the possible roles might be." Lantos also likes Solomonic Judgments: Studies in the Limitations of Rationality, by Jon Elster (Cambridge University Press, 1989). "Elster considers decisionmaking under conditions of uncertainty. He highlights situations where either the costs of being rational or the demands of formulating a problem rationally mean that attempting a rational choice may itself be irrational. His view, in many cases, is that the most rational decision may be to flip a coin. And Lantos recommends David Kirp's Learning by Heart: AIDS and Schoolchildren in America's Communities (Rutgers University Press, 1989). "It's the story of how eight different American school districts dealt with the problem of whether to admit kids with AIDS to their schools," he says. "Kirp takes AIDS out of a medical context and puts it into a social and anthropological one."

Bruce Jennings, executive director of the Hastings Center, a private, nonprofit center for research on ethics in medicine and the life sciences in Briarcliff, New York.

Jennings recommends Stories of Sickness, by Howard Brody (Yale University Press, 1988), because, he says, "it takes seriously the patient's point of view," reminding us that "medicine is not an exact science but at least partly a narrative science--part of the humanities, really. People don't take what happens to them and their bodies just as biological and scientific facts, but make a meaningful story of their illness and death. Ethics and values come into it naturally--not just the doctor's values but the patient's." Jennings praises Ezekiel J. Emanuel's The Ends of Human Life: Medical Ethics in a Liberal Polity (Harvard University Press, 1991) for "showing how bioethics, as it's developed since the late Sixties, has been a field that's philosophically and ethically linked to liberalism, in which the individual is the locus of rights and moral values." Emanuel, on the other hand, says Jennings, "works out a communitarian bioethics. He transforms the questions rather than answering them, arguing that the liberal framework doesn't give us the conceptual tools to understand the issues."

Marc Rodwin, associate professor at the School of Public and Environmental Affairs at Indiana University, Bloomington; author of Medicine, Money, and Morals: Physicians' Conflicts of lnterest (Oxford University Press, 1994).

Rodwin says that his favorites books in the field "challenge traditional ideas by admitting new viewpoints from political theory, law, economics, or social theory" Just Doctoring: Medical Ethics in the Liberal State (University of California Press, 1991), by physician and lawyer Troyen A. Brennan, he says, "does a particularly good job of broadening customary notions about the patient-doctor relationship and showing that medical ethics cannot continue to evolve unaffected by intellectual and economic currents." Like Jennings, Rodwin singles out Emanuel's book for praise. He also recommends Balancing Act: The New Medical Ethics of Medicine's New Economics, by E. Haavi Morreim (Kluwer, 1991), for the way it "discusses how pressures to contain medical-care costs challenge traditional notions about doctors' fidelity to their patients."

--Molly McQuade

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