Global Bioethics: Building on the Leopold Legacy (review)

Abstract

physicians? Are they too weak physically and constitutionally to handle the demands of OB/Gyn? The issue was debated in the United States until the last decade. Women are finally accepted into the field, but must now deal with the problem ofbeing physician, wife, homemaker, and mother. It would be interesting to trace this development from "weak sister" to "superwoman" in a future book. Medical advertising was used in the nineteenth century, and condemned by some, just as it is today. The second major strength lies with the exciting story that Moscucci tells. Why did hospitals devoted to the care of women develop? Why did a medical specialty devoted exclusively to the care of women's problems flourish? The reciprocal arrangement, specialized and exclusive care of men, was not established . This book gives rational explanations for this interesting phenomenon, which tell us much about both men and women. Also tucked into the book are interesting vignettes concerning the controversies surrounding the use of the vaginal speculum and the examining table stirrups. There are some weaknesses. Greed, and the desire for power and status, are given prominent roles as motivators of men's actions. But what about the possibility that at least some physicians, and other health care workers, were compelled to action because they were appalled by the high infant and maternal mortality rates in the nineteenth and early twentieth centuries and wished to do something about it? Specialization, with the gathering of new knowledge, would be a rational way to accomplish this. Another weakness is the difficult writing style. Whole passages can be read and the message being presented remains difficult to discern. Areas are repetitive. Unfortunately, this problem is most pronounced in the first chapter, so that readers may give up and never get to the very interesting and well-written last chapter concerning the establishment of the Royal College of Obstetricians and Gynaecologists. The book is most suitable for individuals interested in studying the development of modern medicine and the changing role of women in society. The extensive notes and bibliography will be an invaluable resource to anyone performing research in these areas. American OB/Gyn physicians will find it less appealing, because of its British context and the difficult writing style in the early part of the book. The high price assures that this will not be a book that physicians, health care workers, or lay people will buy for an evening of light reading enjoyment. James R. Schreiber Department of Obstetrics and Gynecology University of Chkago Chkago, Illinois 60637 Global Bioethics: Building on the Leopold Legacy. By Van Rensselaer Potter. East Lansing: Michigan State University Press, 1988. Pp. 203. $9.00. Bioethics, as defined by Van Rensselaer Potter in 1971, is a form of wisdom that combines biological knowledge and human values. In his recent work, Global Bioethics, Potter's aim is to explore this approach as it applies to current medical 464 Book Reviews and environmental issues. He retrieves the work of Aldo Leopold, the noted conservationist and writer born in 1887, who described an ecological ethic as complex and relativistic: values are defined by their balance and proportion within a natural, dynamic, and interdependent system. On this foundation, Potter argues that species survival and environmental preservation are self-evident criteria of what is morally right. He believes that these two criteria should guide all decisions on individual, national, and global levels. In asking the reader to accept this moral worldview, Potter's text is both compelling and problematic. Two significant themes underlie Potter's discussion of the field of bioethics. The first concerns Potter's presupposition that species survival and environmental preservation are biologically derived, philosophically indisputable moral imperatives . Untroubled by the conceptual problem of the naturalistic fallacy (i.e., that "ought" cannot be derived from "is"), Potter assumes a perfect coincidence between the "is" of the biological facts pertaining to survival and the "ought" of ethics. With this thoroughly naturalistic epistemology, the philosophical task of providing reasons for ethical positions is supplanted by an almost antiintellectual appeal to biological common sense in which imperatives for action follow from facts about survival in an axiomatic fashion. Sociobiologists and evolutionary theorists, including Charles Darwin...