452 - Law, Medicine, and Social Justice

Law, Medicine, and Social Justice
By Larry I. Palmer
Louisville, Westminster/ John Knox, 1989. 168 pp. $15.95

In less than two hundred pages, Larry Palmer comes to grips with one of society's most pressing but little understood problems-the interaction between law and medicine. Over against the various themes and areas in which these two disciplines touch-don't touch-conflict-repelattract-understand-misunderstand-and-understand, Palmer returns to his basic thesis. This thesis is that society suffers from the individualistic and economically driven direction of the interaction of law and medicine; in place of this be offers both analysis and suggestions for "broader institutional functions."

The work proceeds to analyze the institutional approach to law and medicine by looking carefully in Chapter I at "Liability Rules and the Entitlement to Health." Any reader who is not a lawyer or unaccustomed to wading through legal-type language will, in this chapter, put the book back on the shelf muttering, "sounds like a lawyer." But the next five chapters are, if not easy reading, at least more familiar ground for non-lawyers. Hospitals, physicians, social obligations, care of the critically ill, legislative reform, caring for children, and malpractice are all examined carefully, and there are well-chosen and interesting cases to add flesh to the bare-bones concepts.

But this is not a book for the average reader, nor would I recommend it for preachers looking for sermon inspirations or even concerned citizens seeking to understand the issues. Who should read this book? Hospital ethics committees-if they are willing to work at it; undergraduate and graduate students studying social issues and reforms will find it very useful; and professors of courses in both graduate and undergraduate school would be well advised to put it on their reading list. Almost anyone who is willing to dig in and wants to learn about medicine, medical ethics, and health care issues in this decade would find the book useful.

On the plus side then is Larry Palmer's timeliness, his thorough documentation of every authoritative statement, and his optimism-he believes we can do something about the "mess," and be describes where and how we might try. I was especially pleased with his final five pages in which he admonishes us to think about "health rather than progress in medicine" and then moves on to urge more interdisciplinary courses (in all higher education) because "being a professional is not simply an extension of scientific knowledge but part of artistry."

More critically I take issue with the author's optimism (not naive). He does not deal enough for this reader with the probability that the solution to the problems be describes so carefully will be driven more by economics than by either law or medicine. To paraphrase his final chapter on "The Path Toward Caring and Justice," I'm afraid that I see

454 - Law, Medicine, and Social Justice

American business with its consumer mentality erecting short order shops along a path Larry Palmer believes should be a noble thoroughfare.

Daniel C. Dearment
Presbyterian Medical Center
Philadelphia, Pennsylvania