I began reading Alasdair Maclean's book a couple of hours after arriving at the accident and emergency department of my local hospital following a particularly undignified encounter with a staircase. As the receptionist demanded that I share the details of my injury and medical history in front of the crowds of people crammed into the small waiting room, the dissonance between “ideal” ethicolegal practice and the realities of clinical work were particularly preoccupying. For as Maclean states at the outset of his book, influenced no doubt by his dual life as a clinician and bioethicist, the daily enactment of ethical practice has pragmatic aspects.
Bowman D. Autonomy, Informed Consent and Medical Law: A Relational Challenge. JAMA. 2010;303(16):1648-1652. doi:10.1001/jama.2010.500