Julian's Jabberings

Books reviews, current events, and other musings

Sunday, January 29, 2006

First, Do No Harm

In First, Do No Harm, journalist Lisa Belkin examines how life-and-death decisions are made at Hermann Hospital in Houston, Texas. She describes a handful of ethically challenging cases. A terminally ill teenager requires additional desperate measures to prolong his painful existence. A premature baby stays alive through massive intervention techniques, but has a poor long-term prognosis. A poor immigrant is paralyzed from the neck down by a bullet wound, but indicates by blinking that he wants to continue living.

Belkin presents the views and feelings of the main players involved in each case: doctors, nurses, hospital administrators, family members, and when possible, the patient. She records the dynamics of the hospital ethics committee that handles any contentious decisions. She presents the arguments made by each side, without stating her own judgment about the right course of action.

The events of the book occurred in 1988, and medical technology and processes have obviously evolved since then. Still, medical practitioners continue to face similar issues about how far to go in prolonging someone's painful existence and who should make the final decision. The book itself reads as a novel, painting a vivid picture of the people at the hospital and their concerns.

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