Belkin, a New York Times medical reporter, offers a detailed account of the rigorous moral and ethical considerations given to decisions made in the cases of several patients at Hermann Hospital in Houston, Tex., in the mid to late 1980s. By means of convincing dialogue and clear explanations of pertinent medical issues, she brings her readers into medical staff debates and through perilous operations, joyful remissions and death watches. The stories of Patrick, a dying 15-year-old; Armando, an adult quadriplegic; and Taylor, a premature infant who could fit into her father's hand, are presented in a novel-like narrative that also profiles the changes in hospital policy during cost-cutting times. Sympathetic portraits of hospital staff, patients and care-givers include images not easily forgotten: a father saying good-bye to his soon-to-die infant son and a terminally ill teenager writing in crayon, ``Leave me alone,'' as his mother talks to him about death. First serial to the New York Times Magazine and Redbook. (Feb.)
Taking her title from the physicians' Hippocratic Oath, Belkin, who covers medical issues for the New York Times, spent nearly three years with the Hermann Hospital Ethics Committee in Houston, Texas, researching this provocative book on medical ethics. The daily, convulsive questions of life and death that the committee struggles with are often questions without answers, yet they are somehow answered at the Hermann Hospital and in hospitals across the country every single day. Belkin quotes a Chinese proverb: if you save a life, you are responsible for it. The cruel, deceptively simple wisdom of this proverb is brought home on nearly every page of this entirely true, gripping, and dramatic account of how medical chance and technology trap the unsuspecting in a vise of brutal decision-making. Totally engrossing and highly recommended. For a theological perspective on medical ethics, see the review of Theological Voices in Medical Ethics on p. 122.-- James Swanton, Albert Einstein Coll. of Medicine, New York
School Library Journal
YA-- A look at medical ethics and the critical-care decisions made by the ethics committee, doctors, and four sets of patients/parents at Hermann Hospital in Texas between May-October 1988. Quality of life is measured against longevity and consideration is given to expenditure of limited resources. As most of these patients were children or young adults, the book has immediacy for high school students. The epilogue, written four years later, brings closure to decisions made. Young people interested in medicine or the health-care crisis are sure to find this involving.-- Barbara Hawkins, Oakton High School, Fairfax, VA
Belkin's report on the work of the Institutional Ethics Committee at Hermann Hospital in Houston graphically demonstrates several of the major ethical problems and conflicting attitudes that trouble medical people, hospital administrators, patients, and families as they make literally life-and-death decisions. Decisions about such patients as 15-year-old Patrick, who suffers a disorder of the digestive tract and, after many operations, is at the point of death; Taylor and Jake, who are premature twins; Armando, 24, shot through the spinal cord; and Landon, born with spina bifida. The meetings of the committee, sometimes highly emotional, evoke sentiments from many points on the medical spectrum, which ranges from "our job is to keep the patient alive" to "we must see our patients as individuals who deserve dignified deaths." As Belkin writes, "This book is about making choices--and living with them." Excellent for stimulating ethics discussion groups as well as for giving all those who feel represented in its pages something to ponder.