medical Ethics Reviews. 157 pp. Humana ... Ethicists and health care profession- als in reproductive .... native Health and Medicine Encyclopedia. Some of the ...
sante, mettant en evidence le concept de multidisciplinarite. Les 12 chapitres de cette section sont souvent trop superficiels. On note l'absence du role de l'orthophoniste et des diverses specialites (omnipraticiens, infectiologues et autres specialistes). La section sur les familles est tres bien ecrite et trouve sa force dans la presentation de demarches et d'exempies concrets. A noter tout particulierement la description detaillee de l'application du modele d'intervention aupres de deux familles d'ethnies differentes (chapitre 18). Les deux prochaines sections, sur l'adulte et l'enfant infecte, sont de qualite variable. La description des traitements medicaux est souvent trop superficielle pour etre utile et ne tient pas toujours compte des informations disponibles meme "a l'automne 1994. Les chapitres sur les soins palliatifs et sur les effets du SIDA chez les femmes (excellent resume systematique des connaissances) meritent d'etre soulignes. Les meilleurs chapitres de ces deux sections sont ceux qui decrivent le role de l'in-firmier ou l'infirmiere dans lIequipe de soins. La section sur les entourant l'infection par le VIH est tres irreguliere dans sa conception. Le chapitre sur les infections opportunistes nous donne un bon apercu global de la problematique, mais aurait ete mieux place dans la quatrieme section de Meme que le chapitre sur les problemes de sante mentale. Les chapitres sur la stigmatisation, la douleur, l'incertitude et le choix de la fin de la vie sont fort utiles. La section suivante, sur le contexte socioculturel du SIDA, est plutot philosophique, mais presente des concepts importants. La derniere section, une mise au point, est tres repetitive. 11 aurait ete mieux de donner l'exemple d'un projet de recherche resultant d'une collaboration productive entre les milieux universitaires et communautaires plutot que de presenter Ia recherche
comme un modee 'a rejeter. Tout au long du livre, j'ai ete d6qu du manque de tableaux pouvant resumer des concepts plus simplement qu'un texte continu. Dans certains autres cas, on remarque que la meme information est presentee dans trois ou quatre chapitres et sections differentes. Ce volume s'est donne un mandat tres large, qu'il n'a malheureusement pas reussi 'a remplir dans tous les cas. Neanmoins, il constitue un bon livre de reference pour ceux qui s'initient au domaine, particulierement les professionnels de la sante (surtout les infirmiers et infirmieres) autres que les medecins. Pour ces demiers, des ouvrages de reference mieux adaptes a leurs besoins existent dej'a sur le marche. Ceci etant dit, la presentation du modele multidisciplinaire de soins, qui constitue le noyau de l'approche de Reidy et Taggart, n'est pas a negliger: il revient a tous ceux qui traitent des personnes infectees au VIH de connaitre ce modele et de l'appliquer. Brian Conway, MD, FRCPC Directeur adjoint Clinique des maladies infectieuses Hopital Saint-Paul Universite de la Colombie-Britannique Vancouver (C.-B.)
REPRODUCTION, TECHNOLOGY, AND RIGHTS Edited by James M. Humber and Robert F. Almeder. Biomedical Ethics Reviews. 157 pp. Humana Press, Totowa, NJ. 1996. $44.50 (US). ISBN 0-896-03326-0 Overall rating: Strengths: Weaknesses: Audience:
Good Topical and well written Expensive; uneven quality Ethicists and health care professionals in reproductive medicine
This book is a topical collection of essays on the moral and ethical choices that society faces as a
result of the new reproductive technologies. The issues include abortion and fathers' rights, induced abortion and selective termination, the allocation of scarce health care resources for in-vitro fertilization and embryo transfer, cloning, gene therapy and use of the information available from prenatal genetic testing.
The book is divided into three parts. The first deals with the dilemma of a woman's unqualified right to an abortion and a man's absolute moral and legal duty to support a child he does not want. The issues are debated in three essays that, despite their logic, make no good argument for relieving a man of his traditional duty to support his children. The second part deals with blastomere separation and cloning. In contrast to the report of the Royal Commission on New Reproductive Technologies, an essay in this book argues in support of these techniques. A second essay considers assigning government financial support for in-vitro fertilization on the basis of priority, but it is a weak echo of the oft-cited Royal Commission report. This essay ventures into a misguided discussion of evidence-based medicine and so loses ethical credibility. A final essay in this part supports selective termination. The final section supports not only a woman's right to abort a very abnormal fetus but also her obligation to do so, which arises out of a duty to the abnormal child. A final essay argues against the termination of an abnormal but not severely affected fetus, such as a fetus with dyslexia, The essay argues for compassion for and commitment to people with special needs. This is a good -book that offers a friendly, secular approach to the ethical debates over abortion, assisted conception and prenatal diagnosis. The book achieves its purpose well; however, it is expensive and will
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therefore likely have a limited read- to managers on relieving stress ership. among employees. The book's strength lies in the first two sections, Arthur Leader, BA, MD, FRCSC which are full of case examples. The Professor of obstetrics, gynecology author's bias toward the so-called and medicine "medical model" is strongly reflected Chief in the later chapters. Division of Reproductive Endocrinology The book is written in clear, conand Infertility cise language, with very little psyUniversity of Ottawa Ottawa, Ont. chological or medical jargon. The soft-cover version is reasonably priced. I would feel comfortable recommending the book to my patients WELLNESS AT WORK: and to my medical colleagues in general practice. BUILDING RESILIENCE TO JOB STRESS Valerie O'Hara. 229 pp. New Harbinger Publications, Oakland, Calif./Raincoast Book Distribution Ltd., 8680 Cambie St., Vancouver BC V6P 6M9. 1995. $44.95, hardcover; $22.50, paperback. ISBN 1-57224-031-8, hardcover; ISBN 1-57224-030-X, paperback
OveraH rating: Good Strengths: Easy to read, offers practical advice and good case examples Weaknesses: Somewhat repetitious, too simplistic Audience:
in several instances Health care professionals and their patients
WelIness at Work was written as a source of information for health care practitioners and their
clients about managing job-related stressors. It sets out to help workers identify the sources of their stress, and it offers techniques to deal effectively with stress. One of the greatest strengths of the text is the numerous case examples that illustrate our physical, emotional and behavioural responses to stress. Included is a personal "stress profile" to allow readers to determine "where they are at" and to reevaluate th-eir resilience to future stressors after undertaking the recommended exercises. The book is divided into four sections: a discussion of the physiological and psychological aspects of stress, hands-on techniques to relieve stress, an outline of profes-
Richard Hershberg, MD, FRCPC Head Division of Geriatric Psychiatry Toronto East General Hospital Toronto, Ont.
THE FAMiLY DOCTOR
(CD-ROM) 4th ed. Allan H. Bruckheim. Creative Multimedia, 600-225 SW Broadway, Portland OR 97205. 1995. $49.95 (US). ISBN 188042881-4
System. requirements: IBM-compatible personal computer with 33-MHz 486 or higher processor, Windows 3.1 or higher, 4 MB RAM for Windows 3.1, 8 MB RAM for Windows 95, 5 MB hard drive space, doublespeed CD-ROM drive, 256 colour SuperVGA monitor, SoundBlaster-compatible sound card Overall rating: Fair Strengths: Some stunning graphics, huge amount of information Weaknesses: Poor graphical interface Audience: The public
the Family Doctor, a CD-ROM-
based computer program, is aimed at the lay user. According to the box it comes in, its purpose is to let users "get answers to all [their] health concerns." The sheer volume of information on this CD-ROM is incontestable. Unfortunately, the manufacturer, Creative Multimedia, has failed to provide an easy way to handle all of sional resources available, and advice this material.
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The CD-ROM contains seven textbooks: the American Hospital Association's A Patient's Rigbts, the National Safety Council's First Aid Handbook, Advice for the Patient -Drug Information in Everyday Language (USP Dl, vol. 2), Questions and Answers from nationally syndicated columnist Dr. Allan H. Bruckheim, The Random House Health and Medicine Dictionary, Symptoms and Early Warning Signs and The Alternative Health and Medicine Encyclopedia. Some of the graphics, such as one of the human ear, are stunning if the user has a high-resolution monitor and video card. The user can rotate the three-dimensional representation to get a clear picture of the structure from all angles. The Family Doctor includes audio segments, visual imagery and animation as well as interaction with the user. Unfortunately, the end result is complication rather than clarification. This CD-ROM cannot compare with the efficient, text-based search engines of such programs as SAM-CD: Scientific American Medicine or Stat!Ref. The audio component of the program achieves nothing. Listening to a "talking head" explain what is happening is intriguing the first time. After that, the voice gets in the way, and listening to it takes much longer than reading a few instructions. Being told by a patronizing voice that you have made a good choice in a quiz soon grates on you. The quality and presentation of material is uneven. Quizzes in the program are accompanied by rudimentary graphics barely more advanced than stick-figure drawings. Recommendations about various health care interventions are in conflict with the recommendations of the Canadian Task Force on the Periodic Health Examination. I tested The Family Doctor on a computer with specifications that exceed all of the system requirements for this program listed on the box, but the graphics still ran very slowly. The Family Doctor does not fill the
