Ethics and the metaphysics of medicine : reflections on health and beneficence /

It is difficult to write a cogent "hybrid" text; that is, one that effectively merges issues in distinct disciplines. Richman's work is a masterful example of such a text. Richman (Massachusetts College of Pharmacy and Health Sciences) knowingly melds together important issues in metaphysics, medicine, and (theoretical and applied) ethics. The outcome of his project is the Richman-Budson theory of health. This theory is identified as a preference-satisfaction embedded, instrumental theory of health. As such it has two fundamental features: it is cognitivist in that it "entails that there are true and false claims about health," and it is intrinsically normative in that it is (at least in part) motivated by the practical interests (preferences and goals) of concrete individuals, where such individuals are understood primarily as persons, not as organisms. These two aspects of the Richman-Budson theory have important implications for some of the most critical issues in modern health care. Richman wisely explores several of these implications, including the consequences his theory holds for advanced directives, patient-physician relationships, and evidence-based medicine. This is a carefully researched, carefully argued commentary on the nature of health and the state of medicine. ^BSumming Up: Recommended. Upper-level undergraduates and above. H. Storl Augustana College (IL)