Book Review

Encyclopedia of Bioethics

N Engl J Med 1995; 333:466-467August 17, 1995

Article

Encyclopedia of Bioethics
Revised edition. Edited by Warren Thomas Reich. 2950 pp. in five volumes. New York, Macmillan, 1995. $425. ISBN: 0-02-897355-0

Over the past 30 years bioethics has developed into a full-fledged academic discipline. The field has professional societies, university degree programs, and clinical fellowships. The forum for scholarly discourse includes textbooks, edited anthologies, case books, and journals. Most schools of medicine have departments of medical humanities or bioethics, and most hospitals have some sort of institutional ethics committee. With the publication of the second edition of the Encyclopedia of Bioethics, this explosion of educational resources finds a critical repository.

The first edition of the encyclopedia was published in 1978. In the 17 years since its publication, bioethics has changed enormously. Some new topics, such as the use of frozen embryos, multiple-organ transplantation, and somatic-gene therapy, have arisen as a result of technological innovation. New disease entities, such as the human immunodeficiency virus, have prompted a reanalysis of the older bioethical concepts of individual liberty and the public good. Advances in molecular genetics have led to a resurgence of interest in such classic philosophical areas as determinism and reductionism. As compared with the first edition, the second not only has many new topics, but also has been extensively revised and updated.

The second edition consists of five volumes encompassing 464 articles by 437 contributors. Most authors are established experts in bioethics. Along with a superb set of section editors and American scholars, the second edition has a diversity of younger scholars and reflects international perspectives.

The authors, like the field of bioethics, are cross-disciplinary, including not only those from the standard disciplines of philosophy, law, medicine, and theology, but also historians, sociologists, and anthropologists. The encyclopedia moves beyond the dominant Anglo-American perspective to include minority and cross-cultural analyses. It has also moved beyond the U.S. preoccupation with a Western liberal philosophy that focuses almost exclusively on autonomy, rights, and justice.

There are entries addressing the rich tradition of virtue ethics as well as casuistic, narrative, and feminist critiques. In fact, these philosophical entries and the series of entries on the history of medical ethics and religious traditions could easily be pulled together and published as a separate introduction to the field of bioethics.

The encyclopedia addresses general topical areas including the professional–patient relationship, public health, health care, reproduction, experiments involving humans and animals, mental health, death and dying, sexuality, genetics, transplantation, and the environment. The entries are alphabetical, with extensive cross referencing of each entry. There is also a superb index. The appendix contains medical-ethics codes, various forms and directives, relevant federal regulations, and other primary source material.

The encyclopedia is the place to start to obtain a clear and concise overview of any topic in bioethics. The general citations to the literature found at the end of each entry point the reader to more specialized works. When complemented by computer searches on Medline and Bioethicsline for the most current literature, this overview and the general bibliographies should be all a general reader needs to explore the maturing field of bioethics.

The encyclopedia's five volumes are well bound and a convenient size. The paper quality is coarse and thick enough to withstand repeated use. The typeface is crisp and clean, making the entries easy to read. The Encyclopedia of Bioethics will be a basic resource for all medical school libraries and will be a required reference work for most hospital libraries as well. Physicians with a keen interest in bioethics and members of institutional ethics committees will also find a personal copy an invaluable resource.

Michael A. Grodin, M.D.
Boston University Schools of Medicine and Public Health, Boston, MA 02118