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Book and Media Reviews
August 27, 2008

Biomedical Ethics: A Multidisciplinary Approach to Moral Issues in Medicine and Biology

JAMA. 2008;300(8):967. doi:10.1001/jama.300.8.967

Biomedical Ethics contains more than 100 essays previously published in the journal Medical Ethics, many with commentaries and responses. Overall, the book is a satisfying read that presents many different complex ethical problems in an engaging manner. Many of the dilemmas highlight just how complicated bioethics and medical science have become in the 21st century. For example, one essay analyzes the case of a 42-year-old infertile woman who wishes to become pregnant via in vitro fertilization (IVF) using a donated egg. To maintain a genetic link to her child, she requests that her 70-year-old father be the sperm donor. (Genetically, the child would be her half brother.) The IVF staff is concerned that the pregnancy will constitute a forme fruste of incest. Arthur Wolf examines this question and concludes that the only reason not to perform the procedure is the moral repugnance on the part of the clinic staff and that this repugnance alone does not justify a refusal. His conclusion, however, overlooks the significantly increased risk of developmental abnormalities that arise with increasing paternal age and with IVF. Such is the problem with ethical dilemmas; often the complexity of reality ends up confounding a perfectly good analysis.