Ethical Dilemmas and Nursing Practice

Ethical Dilemmas and Nursing Practice

to the nurse starting in the administrative field. In her second edition, Alexander has updated information in the historicalportion of the book, but ...

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to the nurse starting in the administrative field. In her second edition, Alexander has updated information in the historicalportion of the book, but it remains basically identical to the first edition. After this, however, there are many differences. There is a current and good explanation revolving around collective bargaining, labor relations, strikes, and management’s role. Improvements in nursing practice and their impact on nursing today are also discussed. Alexander frequently stresses the need for more active review and legislative processes. A highly sophisticated section of the book addresses technological devices and the use of flow charts and computers. The prime lesson we can gain from this is that nurses must learn to use these devices to assess clinical needs and increase the care given to their patients. Basic management skills are not left out, and descriptions of the unit management concept along with staffing programs, budgets, quality control, and audit review bring the book to a close. Well-writtenfinal chapters describe various forms of leadership and are a good introduction for the novice manager and a good review for the “old-timer.” Joanne Oliver, RN Houston, Tex

Ethical Dilemmas and Nursing Practice. Davis, Anne J; Aroskar, Mila A. AppletonCentury-Crofts, 292 Madison Ave, New York, NY 10017, 238 pp, $10.95 paperback. Two groups of people will enjoy this bookanyone who has taken a recent philosophy or medical ethics course or nurses involved in research. Rights of patients, informed consent, abortion, dying and death, behavioralcontrol, mental retardation, and professionalethics and institutional constraints in nursing practice are thoroughly discussed. Challenging the reader, the authors raise question after question on each topic and give no answers. Obviously, the object is for the reader to assess his or her feelings and biases on the subjects in relation to the pros and cons offered in the book. It is not easy to do. This book is not the kind you start unless you are alone in a quiet place and committed to a “thinking” period without inter-


ruptions. It is also a book you cannot finish in one evening if you are trying to do a real selfassessment on the ethics of the questions raised. These questionsshould be raised, and each professional nurse should try to answer them before he or she is faced with a situation that requires dealing with one of these dilemmas. With an impressivebibliography, this book is a contribution to nursing literature, and it should be read before the nurse feels the need for professionalguidance involving ethics and morals. Martha Hoffman, RN Greenviiie, Pa

Laetrile anticancer diet called unhealthy The “anticancer” diet proposed by laetrile advocates “is as unhealthy for cancer patients as it is possible for the mind of man to conceive,” according to a letter in the Journal of the American Medical Association (Sept 8). Victor Herbert, MD, of the VA Hospital, Bronx, NY, and the State University of New York Downstate Medical Center, Brooklyn, analyzed the diet that is supposed to accompany the taking of laetrile. The diet bans meat, fish or fowl, and dairy products. It calls for greatly increased eating of fruits and vegetables. Such a diet is high in bulk and low in calories, just opposite to needs of cancer patients, says Dr Herbert. The diet also prescribes massive, probably harmful doses of vitamins. Laetrile has been around in fringe medical circles since 1835. It has never been found to have any value in human nutrition or to be of any value against cancer, Dr Herbert declares. In the time of the pharaohs, the extract of apricot pits (the basis of laetrile) was used for official executions since it contains cyanide. Laetrile may actually cause cancer, rather than cure it, Dr Herbert says. News reports have indicated there has been relatively little demand for laetrile in those states that have legalized its sale and manufacture.

AORN Journal, November 1978, Vol28, No 5