The following appeared in Volume 98, Number 2 (Spring, 1999) of the APA Newsletters

Some years after his well received and by now well known work, Classic Cases in Medical Ethics, Gregory Pence has assembled a rather impressive anthology entitled Classic Works in Medical Ethics: Core Philosophical Readings. This collection ranges over some of the most important issues in medical ethics-- euthanasia, abortion, assisted reproduction, involuntary psychiatric confinement, genetic engineering and the just allocation of medical resources. Furthermore, the term ‘classic’ in the title is by no means a misnomer, as the book includes articles by such notables as, among others, James Rachels, Daniel Callahan, Judith Jarvis Thomson, Ruth Macklin, Peter Singer and Michael Tooley. Substantively, and given the contributors, this should come as no surprise, it provides a fairly well rounded approach to the subject matter.

The work begins with an introduction to ethical theories by Pence in which he briefly traces the development of Western morals from the Ancient Greeks down to John Rawls. He provides a concise summary of classical virtue ethics, natural law theory, deontology, utilitarianism and social contract theory. Pence then turns to the field of medical ethics proper and focuses on the ‘four principles’ approach made famous by Beauchamp and Childress and he subsequently considers two objections to this approach, a feminist ethics of care as well as the ‘case-based’ or casuistical method. While nicely summarized, the shift from general ethical theories to medical ethics is somewhat disjointed. Perhaps a more fruitful strategy would have been to present the medical ethics as primary and then relied on the various ethical theories mentioned to provide some justificatory force for the bioethical framework in question (e.g., concerning the ‘four principles’ approach discuss Kant in the context of the principle of autonomy, utilitarianism in regard to the principle of benevolence, etc.). Although this would call for a much longer introductory piece it would provide a nice theoretical backdrop and various points of reference for the subsequent readings.

Structurally, and as noted above, the book is divided into a number of topics (twelve in all), beginning with "Euthanasia in Incompetent Adults" and ending with "AIDS". The presentation of each topic follows a fairly standard format. Two or three articles of opposing philosophical view points are offered in conjunction with one another. Thus, in the section dealing with abortion we have J.J. Thomson’s "A Defense of Abortion", Mary Anne Warren’s "On the Moral and Legal Status of Abortion" and Don Marquis’s "Why Abortion Is Immoral". Unfortunately, on occasion Pence deviates from this format in that no alternative viewpoint is offered. For example, in the section concerning animal experimentation Peter Singer’s provocative piece "All Animals are Equal" is presented by itself. Clearly, a defense of animal experimentation is necessary to balance out this section.

Aside from the above noted problems and suggestions, Classic Works in Medical Ethics realizes its aim. It provides a thoroughly philosophical and readily accessible introduction to the primary ethical issues which have confronted physicians, as well as the public at large, over the last forty years.