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The New Zealand Medical Journal

 Journal of the New Zealand Medical Association, 03-July-2009, Vol 122 No 1298

The Elderly: legal and ethical issues in healthcare policy
Martin Lyon Levine (editor). Published by Ashgate Publishing Ltd, 2009. ISBN 9780754620440. Contains 590 pages. Price £117.00 (online)
This book is part of a series called The International Library of Medicine, Ethics and Law.
The editor of the series as a whole says its aim is to provide access to basic materials in the area from a number of disciplines, partly on the basis that any one library is unlikely to have access to all the periodicals and books from which the material is drawn.
The elderly are the focus of this volume, edited by a scholar with academic appointments in a number of schools within the University of Southern California, namely law, gerontology, and medicine.
The text contains a series of reprints, all from journals, focussing on legal, ethical, and clinical aspects of the care of older adults, and spanning the years 1982 to 2004.
The reprints are loosely organised into four parts: Healthcare in an aging society, Decision-making for the older patient, Are the needs of the elderly met?, and Distributive justice. The journals are legal periodicals and the clinical and bioethical literature. There is a largely United States focus but journals from the United Kingdom, Hong Kong, and Australasia also feature.
Although there is an introduction setting the scene for the topic the papers are not accompanied by a commentary. It is not clear how the papers were identified or selected for inclusion, and the material is not indexed apart from the grouping of the papers in the contents by sub-topics within each major subject heading. There is considerable variation in the depth of coverage of various topics by the papers selected. For example one reprint is a short commentary on an original piece of research concerning the Oregon State Death with Dignity Act, rather than a reprint of the original research paper. The material is also inevitably out of date in some respects. A paper discussing international trends refers to New Zealand's 10 health boards. If the material concerning other countries is similarly out of date its value may be reduced.
The reprints are taken directly from the journals and resized to fit the book with an uncomfortable reduction in the font size for some reprints, making it difficult for those of us with presbyopia to read the material comfortably. There is also variation in the clarity of reproduction.
The book would be of most use to academics, clinicians, and legal practitioners wishing to get a flavour of the issues around older adults, the law and ethics, rather than an in depth understanding or detailed review of these areas.
Mark Weatherall
Associate Professor, Department of Medicine
University of Otago, Wellington
     
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