Ethical Challenges in Health Care: Developing Your Moral Compass Vicki Lachman, PhD, APRN, MBE. New York: Springer Publishing, 2009, 274 pages, $50.00. Dr. Vicki Lachman, clinical associate professor in the College of Nursing and Health Professions at Drexel University in Philadelphia, has authored a superb book, her second on ethics. Her exposition of ethical challenges is clear and will captivate any health professional. Nurses will benefit most, but all health professions are involved in ethical issues. Lachman's goal for the reader is to develop moral courage and to act in accordance with his or her values, without allowing fear to prevent the right action. Lachman begins each chapter with a meaningful quote and ends with key points to remember. It would have helped to include questions to stimulate reflective and critical thinking. Interspersed throughout the chapters are ethical case histories that provide examples of people experiencing or demonstrating what Lachman is explaining (for instance, cognitive reframing). The first section presents historical figures who defined and personified moral courage. Lachman discusses coping with emotions such as anxiety, fear, anger, and disappointment that can obstruct moral courage, and she offers practical processes to overcome these emotions with rational actions. Additionally, to gain moral courage, one needs assertiveness and negotiation skills. One scenario in which moral courage is particularly important is expressing bad news. A physician may be less than clear and straightforward in telling a patient about a serious health condition, leaving the nurse to clarify the bad news and respond to the patient's questions. These situations call for the nurse's presence, compassion, and honesty. The second section addresses demonstrating moral courage, which is necessary for patient advocacy. One case study describes a 90-year-old patient who chose not to have a recommended surgery even though without it, she would die. If the patient has the capacity for decision making and understands the consequences, then the patient's decision should be supported. Lachman points out the health professional's role in advance directives, which convey patients' wishes when patients are not able to speak for themselves. Sometimes, family members want life support equipment or procedures that the patient's advance directive states were not wanted, but the patient has the right of self-determination. …