An iconoclastic view of medical ethics

SOME CHOICE: LAW, MEDICINE, AND THE MARKET. By George J. Annas. New York: Oxford University Press, 1998. Pp. xvi, 303. $29.95.

George Annas1 is one of the best-known legal commentators in the United States on issues related to health law and bioethics. He began writing a column for the Hastings

Center Report in June 1976 and has been a conspicuous presence on the health law scene ever since. His productivity and scope of interest are impressive, with writings ranging across the entire field of bioethics and health law, attacking hypocrisy, inefficiency, and venality wherever he finds them. All this and more is brought together in this collection of essays, most of which are based on articles originally published between 1991 and 1997.2 Far more than most other pundits, Annas revels in provocative commentary, and even when he is wrong, he is never boring.

This book has many strengths. If medical ethics is about any single thing, it is about protecting and promoting the interests of patients, and Annas's efforts are unflagging on their behalf. His concerns do not rest there. They move beyond the traditional patient-physician dyad to recognize the valid interests of family and society. Although Annas is a professor of law, he argues vigorously that the law should not make medical decisions, but that essentially medical matters should be left to the physicians and patients who are intimately involved. He repeatedly urges the physician to make the medically best decision without worrying about possible legal repercussions.