“Genes do not cause behaviour, but they affect tendencies to behave in certain ways.” Experts in genetics, law, sociology, journalism and philosophy elaborate on this maxim in the book. The first section describes basic scientific concepts, the second section addresses the complex interaction of genes and behaviour, and the third section deals with how this information should be used to formulate public policy.
Neuro-ethics, a sub-field of both neuroscience and bioethics, deals with both the neurological basis of moral and ethical behaviour as well as the specific ethical issues that arise as a result of expansion of research in neurosciences. The author, a distinguished neuroscientist, discusses controversial topics such as “possibilities for brain enhancement, and the relationship between brain function and free will and its implications for personal and legal responsibility.”
A physician has written a memoir reflecting on how medicine has changed during his long medical career and the development of medical ethics in response to those changes. He describes, through individual cases, the ethical climate of the time and the ethical issues he faced, listing his own failures as well as systemic deficiencies.
The author vividly describes the challenges he faced in becoming a doctor. The anecdotes are interesting and trace his path from a medical student to residency and beyond. His message of the uncertainty of medicine would be useful for the lay public as well as those aspiring to be doctors.
The author exhorts physicians to look beyond their own environment and work for improving global health. He describes how poverty creates disease, describing the international and private health organisations which work in the developing world and listing their strengths and shortcomings. The last section of the book has biographies of doctors who have worked heroically in the international medical field.
The author has invited contributors from various fields to discuss the ethics of surgeries that are controversial, such as transsexual surgeries, cosmetic surgeries and sham or placebo surgeries. The book “usefully traces key themes that run throughout the practices examined, including the limits of paternalism, the problems with simplistic ideas of autonomy, and the shifting meanings of normality and disability.”
The authors describe the uncertainty of choosing the best treatment in the absence of sound medical evidence and remind us that we all have a responsibility to find effective treatments through clinical trials. Clinicians must accept uncertainty, patients must be willing to participate in trials, and researchers must take the responsibility to design trials which ask questions that are relevant to clinical practice.
Current American health care is based on the premise that market-driven plans will offer lower prices due to competition. The author cites studies that show that not only have market forces failed to deliver on this premise, they have actually encouraged both over-treatment and under-treatment of patients. However, she fails to factor in the universities which perform unnecessary and duplicative research, driving up costs of health care. She believes that reverting from corporate control to physician-centred care will solve the problems, but the reviewer feels that this is simplistic and unlikely to achieve its goal.