Ethics: The Heart of Health Care

by David Seedhouse

The Heart of Health Care - a classic ethics text in medical, health and nursing studies - is recommended around the globe for its straightforward introduction to ethical analysis. In this new edition David Seedhouse demonstrates tangibly and graphically how ethics and health care are inextricably bound together, and creates a firm theoretical basis for practical decision-making. He not only clarifies ethics but, with the aid of the acclaimed Ethical Grid, teaches an essential practical skill which can be productively applied in day-to-day health care.

This edition, which is even more readable than the first, includes additional case studies and teaching exercises, contains new material on ethical theory and offers two further decision-making tools - The Rings of Uncertainty and the Autonomy Test. The engaging new introduction reveals the genesis of the Ethical Grid, illuminates the intent and argument of the first edition, and explains why the book is needed today as much as ever.

Intended for all who work in health care or health studies - indeed for anyone with an interest in health issues - this is a highly original, innovative and accessible work on a subject traditionally regarded as lofty and obscure. It clarifies a wide variety of complex ethical issues and will give the reader fresh inspiration and renewed confidence in dealing with the demands of modern health work.

250 pages, Paperback

First published September 30, 1991

Reviews

[An Te · Rating 3 out of 5]

An interesting synthesis of ethical ideas focussing upon health. It's a much ignored topic and the book seems to be largely ignored in health spheres which itself leads to unconstructive grounds for health worker's decision-making and actions. David's ethical grid is a compelling creation and it does appear unwieldy with 16 domains to consider prior to decision-making. It is a heuristic I wish to explore further to discover whether it has had any impact on the healthcare since its publication and also to explore its merits and demerits in better allowing health workers to bring about the 'potential of their patients and those care for' and combat the malign values behind 'dwarfism,' the intentional or accidental limiting of people.

This critiques of utilitarian, deontology (consequentialism) are good. The critique of the DALY and QALY are all the more compelling for the argument his opinion is that the QALY (quality0adjusted life year) assumes two myths:

1. One can be certain about health outcomes, how long patients will live, pain equivalence for all and that the QALY contains no assumptions.
2. Human beings are not unique but entirely measurable by the set of a few delimited factors.

But I guess people are moving away from QALY's these days towards the capabilities approach (Martha Nussbaum). I'd like to know of a book which both introduces and critically appraises this approach.

[MM · Rating 3 out of 5]

BLEGH

it's not AWFUL... but it's kinda... unnecessary

Basically this whole book is written for the purpose of introducing "The Ethical Grid". It's basically a bunch of things to consider when you encounter an ethically tense situation in a healthcare situation. They are important and good things to consider, e.g. "create autonomy", "the law", "serve needs", etc, and it's not a bad tool. But a whole BOOK about this? An article, sure. But a book???

The first half of the book talks about deontology and utilitarianism and blah blah. The more interesting parts are that 1) health work is moral work; 2) healthcare is about promoting human potential (not just addressing a deficiency); 3) autonomy (of the patient/client) is a quality - your job as a healthcare worker is to create increased autonomy up till the point respecting her autonomy becomes meaningful (i.e. the "Autonomy Flip"). He also emphasises the importance of *actual* ethical work - what can healthcare workers do in practice, not just in theory. That's where the value of this work comes in - some of the tools are good ways of considering ethically precarious scenarios; they give you a place to start and frame all of your thoughts and to deliberate through.

Maybe this was groundbreaking when it came out or something. Some of the case studies were interesting. The tone of the book is quite pompous, in my opinion - unpleasant to read. I would recommend the later chapters but not the earlier ones, especially if you have even a rudimentary background in ethics.

I didn't finish the book though because a) I didn't really like it; b) I only read this for class and luckily we didn't have to read the whole book!!

also, don't read the Introduction if you know what's good for you.

[Ray Lucas · Rating 4 out of 5]

Presents some pretty awesome tools for Ethical Decision Making