Ethical Practice, West Indian Medical Journal 2005, 54 (4), 273

ISBN: 978-976-640-164-1

Price: US$27 (s)

Ever so often one comes across a text book that is as engrossing as any thriller. Ethical Practice in Everyday Health Care is just such a book. From the very first paragraph, in which Professor Walrond introduces the first of many moral/religious issues (the Roman Catholic Church and contraception), to the very last, which throws out the challenges of the HIV affected orphan, this book is compulsive and enjoyable reading.

The jacket blurb describes it as “useful, practical and student friendly ... the text is simple, comprehensive and factual, addressing issues encountered in everyday medical practices. Case studies provide practical illustrations of complex ethical issues. “ Professor Emeritus the Honourable “Mickey” Walrond himself describes it modestly as “intended as a student-friendly text that seeks not to turn students into ethics scholars but to provide them with a practical guide to ethical conduct in everyday medical practice. “ He intends it to fill a gap left by most medical textbooks and by the more scholarly texts on ethics.

I think the book succeeds wonderfully. In his acknowledgements, Professor Walrond thanks the colleague who suggested that some student exercises should be added. In fact, he added some 86 exercises. While the main text is outstanding for its clarity and logical trains of thought, and the major theoretical aspects of ethical practice are covered (starting with definitions and the Hippocratic oath), the exercises, to my mind, are the real riches of the book. Many of them sound familiar, as if recalled from the monthly Saturday morning ethics conferences in the Queen Elizabeth Hospital Auditorium, coordinated for so many years by the author and now by Professor Harley Moseley. They are invariably true to life and intriguing, and it’s great fun to read the exercise, speculate on the issues and “best ethical practice” and then consult the discussion. The issues are objectively discussed, and when they are muddy this is acknowledged. The importance of seeking second or more senior opinions, or legal advice, is constantly emphasized.

But Ethical Practice in Everyday Health Care should not be considered just a textbook for students. While every medical student should acquire it, read it from cover to cover and return to it for patient after patient, I believe every registered medical and healthcare practitioner should do the same. The fact is that most practitioners graduated with minimal teaching on ethical problems and solutions, and often flounder when faced with difficult ethical decisions.

The Terry Schiavo fiasco, played out over many years finally becoming an international tragicomedy, indicates the complexities and the difficulty of these issues. We all need to know more, to think about the problems more, and to have ready access to a useful guide.

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