BOOK REVIEWS

Bioethics made comprehensible

Sunil K Pandya

DOI: https://doi.org/10.20529/IJME.2012.093


Donna Dickenson. Bioethics: all that matters. London: Hodder Education; 2012. Paperback. 168 pp. 7.99 ISBN 9781444155808

Inspired by her grandmother’s admiration for women with varied skills, Ms Dickenson has developed into a woman of many parts. She has written prize-winning poetry and biographies of eminent women authors such as Emily Dickinson, Margaret Fuller and George Sand. Of American origin, she is Emeritus Professor of Medical Ethics and Humanities at Birbeck College, University of London, and has taught at the Universities of Yale, Oxford, Birmingham and Bristol. She has been awarded the International Spinoza Lens Award for her work in bioethics. She is the first and only woman to win the prize. This award is named after the fact that the eminent Dutch philosopher Baruch de Spinoza ground lenses to generate his daily income.

Ms Dickenson’s earlier works in the field of bioethics includeBody Shopping: the economy fuelled by flesh and blood and Property in the body: feminist perspectives. Both deal with the human body and its parts as articles of trade the world over ‘from BC to AD’.

The goal of her book is included in her definition: “The role of bioethics – from the Greek words bios (life) and ethos (values or morality) – is to debate those issues more rationally, to make sure that the onward march of science doesn’t trample down vulnerable populations, to prevent harms from outweighing benefits, to ask whose interests prevail and to raise questions about whether justice is being served by new scientific developments.” Some of the instances of harms included in her book are the study of precancerous abnormalities in women in New Zealand, with no treatment being offered to the participants; ‘research experiments’ in Guatemala where the US Public Health Service deliberately infected prisoners and mentally ill persons with syphilis; the Tuskegee ‘studies’ in which African-American men with syphilis were monitored over long periods, medical care being deliberately denied, and the injection of malarial parasites, live polio virus and cancer cells into patients without their knowledge in the name of medical research. Chapter 7 includes details on these and other atrocities, and the development of the Nuremberg Code.

In this book, Ms Dickenson has successfully made crucial issues in bioethics comprehensible to students and lay persons. Large font, boxes clarifying or amplifying statements in the text, and portraits of key persona make the book eminently readable. Difficult concepts are simplified without loss of emphasis or gravity. The topics featured here have been discussed in her earlier works but those were intended for experts in her field.

The first chapter sets the pace: Should we do whatever science lets us do?She follows this question with another: What if scientific advances are used to increase social injustice rather than diminish it?

The international market in human organs, eggs and sperm, commercial surrogate pregnancy, and the patenting of human genes are some of the examples used by her. She emphasises the legal status of cells, tissues and organs removed from the human body for whatever purpose. These do not belong to the person(s) from whom they were removed. Details are provided onMoore v Regents of the University of California where the court held that Moore had failed to establish that he had a property right to tissue taken from his body that was used by others to earn three billion dollars (page 138).

Pages 30 – 42 are devoted to surrogate pregnancies in India.

Chapter 4 is a succinct review of genetics. The next chapter highlights the blatant attempts at profiteering by patenting genes that were identified and studied using public funds. The caseDiamond v Chakrabartyis included as a landmark court decision. (pages 86, 136-137)

Work on stem cells is discussed in Chapter 6, and Hwang Woo-Suk’s fraudulent ‘research’ is referred to. She also discusses the risks in the banking of blood extracted from the umbilical cords of new born-babies and highlights the blatant commercialisation inspiring the formation of cord-blood-banks. She paints on a broad canvas and includes the thoughts and views of philosophers, bioethicists and social scientists.

Humour is not missing. Two examples will suffice. She narrates the use of the ‘F’ word by Cardinal Keith O’Brien, and clarifies that he talked of Frankenstein (page 13). She reproduces a cartoon onA critique of pure reasonon page 44.

The concluding section of the book provides two invaluable resources.100 ideas provides lists of books on bioethics; landmark court decisions; literary works; films; websites; think tanks and activist organisations; key concepts; key thinkers and key persons who have shaped the field for better or worse.Notesfeature additional explanations and references to the literature on each chapter.

This is an invaluable work for those readers who are not bioethicists. The latter, too, will find much of interest, including a practical lesson on how an intricate subject can be presented in a simple and easily understood format.

About the Authors

Sunil K Pandya (shunil3@gmail.com)

Department of Neurosurgery

Jaslok Hospital, 15, Deshmukh Marg, Mumbai 400 026

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