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Tong, a well-known biomedical ethicist, combines medical ethics, bioethics, and her own unique insights to provide a comprehensive survey of contemporary health care ethics issues. The following is a book review of Rosemarie Tong, New Perspectives in Healthcare Ethics: An Interdisciplinary and Cross-cultural Approach. ISBN 13: 978-0130613479 ISBN 10: 0130613479 Suggested Retail Price: $61.80 Cover: Paperback Pages: 368 Copyright: 2007, Upper Saddle River, New Jersey: Prentice Hall New Perspectives in Healthcare Ethics 2 New Perspectives in Healthcare Ethics: An Interdisciplinary and Cross-cultural Approach by Rosemarie Tong Book Review New Perspectives in Healthcare Ethics: An Interdisciplinary and Cross-cultural Approach is unique because its focus is healthcare ethics, not medical ethics or bioethics. Accordingly, it does not assume a model of healthcare that focuses on the physician. The physician is regarded as a member of a healthcare team whose goal is patient care. As a result, the kinds of issues it addresses do not exclusively cluster around those coming through the patient-physician relationship; namely, bedside or clinical ethics, the treatment of disease and alleviation of suffering. While it includes these topics, other contemporary healthcare issues are addressed. For example, those arising with long-term patient care outside of the hospital setting. And, because it includes perspectives from a variety of healthcare professionals, these traditional topics are presented through multiple lenses; including cross-cultural. The text is best used for undergraduate courses in applied ethics, moral issues in healthcare, healthcare ethics or a bioethics or medical ethics course that may be taught as a healthcare ethics course. New Perspectives in Healthcare Ethics 3 The text begins with a discussion of ethical theory. Tong helpfully distinguishes subjectivism and relativism from pluralism and offers the rules of conceptual engagement for a reasoned and pluralistic analysis of ethical issues in healthcare. This is useful because many students bring an unreflective relativist view to ethics courses that at best indicates an underdeveloped belief in the principles of equality and tolerance and at worst, opens the door to nihilism or quietism. In this section, the usual theories are iterated: utilitarianism and deontology. Tong also includes: virtue ethics, a theory that many ethicists have revived as an alternative or supplement to deontology, and utilitarianism. In particular, the virtues relevant in healthcare (trust, fidelity, and caring); natural law ethics (espoused by Roman Catholics and Roman Catholic Healthcare facilities); and contractarianism are elucidated. Also include is a distinction between positive and negative rights: a necessary distinction to understand if one engages the issue of the right to healthcare in the course. Tong, a leader in the field of feminist bioethics, conveys the depth, richness, and multiplicity of voices in feminist ethics. Explicated are all theories though the use of many examples: a feature the students are sure to welcome. In addition, there is a section on principles in healthcare ethics. The four traditional principles of bioethics formulated by Beauchamp and Childress are shown to conflict with each other. However, strategies for balancing and resolving the conflicts are suggested. Instead of delving into an ethical analysis of different kinds of contentious acts in heath care like abortion or human subject experiment, the author starts the content section of the text (chapter three) with a discussion of relationships in healthcare. Tong offers different models of the relationships between the patient and healthcare professional and acknowledges other relationships that effect patient care. These include those between a provider and the institution. This is an important first understanding for students if the instructor believes that situations, concrete embeddedness, or context play a role in healthcare ethics. The next chapter, chapter four, examines concepts of health, wellness, and disease from the perspective of their categorization as to whether these categories are biological, socially constructed, or both. This metaphysical and epistemological grounding of ethical issues is interesting and a welcome addition to traditional approaches in teaching applied health ethics. Questions that could come up as a result of this discussion in class are: What is health as opposed to well-being? What are the New Perspectives in Healthcare Ethics 4 normative and biological aspects of each and what do answers to these questions tell us about patient and provider expectation in care? And, what do answers to these questions tell us about how to educate healthcare professionals? The remaining chapters, chapters five to thirteen, focus on issues that are the standard fare of applied health ethics textbooks: research ethics, abortion, new reproductive technologies, cloning, euthanasia, organ transplants, and health care allocation. Because Tongs approach in the text assumes patient care as a team effort, she acknowledges that care also takes place in non-hospital settings. Readers find this approach a refreshing change. In addition to and among these traditional issues are discussions that are usually not found in the mainstream texts; namely, genetic counseling, ectogenesis, the aging process, long-term care, and palliative care. Student learning features include in every chapter a short introduction and conclusion, a description of social and scientific facts that pertain to the issue, a set of discussion questions, case studies, and a substantial reading list. Key terms are also highlighted in the body of each chapter. It is interesting that the author does not include a glossary of these terms. This gives the instructor the opportunity to teach in accordance with the principles of active or student centered learning: the students are encouraged to make up their own glossaries. Marin Gillis, LPh, PhD, an Assistant Professor of Health Care Ethics and Philosophy and Co-Director of the Medical Humanities Research Group at the Massachusetts College of Pharmacy and Health Sciences on Boston, MA presents a review of Rosemarie Tongs, New Perspective in Healthcare Ethics : An Interdisciplinary and Cross-cultural Approach. Currently, Dr. Gillis is working on ethics of embryonic stem cell research with a particular concern for the commodification of women's reproductive material. She is a steering committee member of the Association for Feminist Ethics and Social Theory and holds memberships in the American Philosophical Association, the Society for Philosophy and Technology, and the American Association of Practical and Professional Ethics Rosemarie Ton, (Upper Saddle River, New Jersey: Prentice Hall, 2007) is a singleauthor text that is the latest in Prentice Halls series, Basic Ethics in Action. It is an extremely clear introductory textbook that is a much welcome addition and corrective to the plethora of applied ethics textbooks that exist on the market. New Perspectives in Healthcare Ethics 5 Additionally, Rosemarie Tong, is a philosopher and the Distinguished Professor in Health Care Ethics and Director for the Center for Professional and Applied Ethics at the University of North Carolina Chapel Hill. She is a prolific writer, a sought after speaker, and a much consulted policy advisor. She has written and edited textbooks including: Women, Sex, and the Law; Ethics in Policy Analysis; Feminist Thought: A Comprehensive Introduction; Feminist Approaches to Bioethics; and Feminist Thought: A More Comprehensive Introduction; Feminist Philosophy: Essential Readings in Theory, Reinterpretation, and Application, (with Nancy Tuana) and Globalizing Feminist Bioethics (with Aida Santos and Gwen Anderson). She is a CASE National Professor of the Year (awarded by Carnegie Foundation and the Council for the Advancement and Support of Education). Author Contact Information Marin Ellis, LPh, PhD, Assistant Professor and Co-Director of the Medical Humanities Research Group at the Massachusetts College of Pharmacy and Health Sciences on Boston, MA Email: marin.gillis@mcphs.edu