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BOOK REVIEW |
Cooper University Hospital Camden, NJ
Ethical Problems in Pediatrics: A Dozen Dilemmas, by Arnold Melnick, DO, presents 12 brief pediatric case scenarios, representing common ethical dilemmas that a pediatrician is likely to encounter. Case presentations are followed by a series of ethics-related "options," or problems, that a practicing physician would have to consider. Dr Melnick then addresses these various options with proposed solutions. Each discussion is followed by a "second opinion" that is written by a different expert—often from an alternative perspective.
Dr Melnick's writing style is conversational, making the book an easy read. However, the book is somewhat repetitive because most of the questions that the author raises are identical from case to case. Readers will note that the author's proposed solutions vary depending on the case at hand and that he often does not arrive at a clear solution, leaving the reader potentially confused regarding the most ethical course of action for a given case.
For example, in one of the presented cases, a physician happens to notice an 8-year-old patient smoking a cigarette outside the elementary school. Should the physician intervene in this case? If so, in what way? Dr Melnick's discussion points out the many complicating factors of this hypothetical situation. Although the young patient is in no immediate danger, he is potentially at the beginning of a long-term unhealthy habit. And yet, neither the patient nor his parents came to the physician with a problem. Thus, intervention by the physician would be akin to "chasing" the problem. As Dr Melnick notes, the physician is likely to wonder if this situation is any of his or her business. Dr Melnick's ambiguous conclusion is, "In this complicated drama of ethics, you must carefully choose what you can do best for this patient and the best choice for you. Then go with it. And hope. And hope. And hope."
Perhaps the lack of clear solutions to such cases demonstrates that the best approaches to issues of medical ethics can be debatable—and sometimes there is not a single "right" or "wrong" answer.
Dr Melnick, currently a retired pediatrician with five fellowship degrees, brings a long and distinguished background as a physician, educator, author, and public speaker to this book. A former president of the American College of Osteopathic Pediatricians and the American Medical Writers Association, he has written six books and about 160 articles. He was the founding dean of the Southeastern College of Osteopathic Medicine in Miami Beach, Fla (now Nova Southeastern University College of Osteopathic Medicine [NSU-COM] in Fort Lauderdale). Later, he was executive vice chancellor and provost of the NSU-COM Health Professions Division. Dr Melnick continues to serve as a professor of pediatrics and public health and he is the author of a monthly column in The DO magazine titled "To the Point."
The "second opinions" offered at the end of the 12 cases in this book were written by nine individuals with diverse educational backgrounds.
Overall, I would recommend this book to any healthcare professional, particularly the pediatrician who is in need of instruction on how to expedite his or her own ethical dilemmas.
Footnotes
By Arnold Melnick, DO. 157 pp, $11.99. ISBN 978-1-4259-9206-4 (sc).
Bloomington, Ind: AuthorHouse; 2007.
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