The Cambridge Textbook of Bioethics is a comprehensive, helpful resource for understanding the breadth of ethical issues that emerge in medical settings. The book is edited by two capable bioethicists, Peter A. Singer, Sun Life Financial Chair in Bioethics at the University of Toronto (not to be confused with Peter Singer of Princeton University) and A. M. Viens, a doctoral student at the University of Oxford. Singer and Viens designed this book to be “a succinct yet authoritative text and reference for clinicians, researchers, bioethicists, and students seeking a better understanding of the ethical problems in the healthcare setting” (p. i). As such it is helpful to theological students and pastors who desire a thorough reference resource.
The book is divided into ten sections: information problems, end of life care, pregnant women and children, genetics and biotechnology, research ethics, health systems and institutions, using clinical ethics to make an impact in healthcare, global health ethics, religious and cultural perspectives in bioethics, and specialty bioethics. A helpful overview essay begins every section. The chapters (written by dozens of contributors from around the world) seek to answer three questions: What is it? (how the concept is to be understood and why it is relevant to clinical practice), Why is it important? (how the concept has relevance from the perspectives of ethics, law, policy, and empirical studies), and How should it be approached in practice? (how the concept can be applied to improve patient care). Each chapter begins with problems from case studies and concludes with potential solutions.
One of the biggest strengths of this book is its breadth. It serves as an excellent resource for getting the basic idea of varying issues, whether that be what is meant by “consent” (ch. 2), the technicalities of brain death (ch. 13), or the challenges presented by bio-banking (ch. 23). The variety of contributors is helpful as well. While the editors pitch in on several chapters, experts from around the world write most of them. This helps to prevent bias and makes the individual parts stronger since the book covers such a vast array of topics (sixty-five total chapters). The pastoral connections are clear. For instance, pastors will find the chapter on truth-telling helpful as they grapple with what role they are to play in telling the truth to patients while also preserving and promoting hope. As other medical issues emerge in the pastoral setting, this resource can provide helpful orientation for thoughtful biblical engagement.
The section on religious and cultural perspectives is interesting in some respects and weak in others. The introduction rightly notes that ethics is a form of worship, and so bioethics cannot be ignored. Alphabetized likely for political correctness (leading off with “Aboriginal bioethics” and concluding with “Roman Catholic bioethics”), the chapters explore unique bioethical problems that emerge in the treatment of people of different faiths. For example, Jehovah’s Witnesses refuse blood transfusions, forcing creative solutions in many cases. And Eastern perspectives, for example, often emphasize the authority of the family in making decisions rather than individual autonomy as in the dominant Western approach. The section is strongest when providing helpful details that will aid medical professionals in interacting with patients from these different perspectives, and it is interesting to learn about the various positions.
Two related weaknesses emerge in this section. First, the quest to be representative has led to an unbalanced treatment of perspectives. Aboriginal bioethics, Buddhist bioethics, and Chinese bioethics receive their own chapters, but then Protestant bioethics receives one and Roman Catholic bioethics receives one. Second and likely due to the first, the chapter on Protestant bioethics is too sparse. It does identify key theological themes such as God’s sovereignty, which play a role in patients’ perceptions of illness and their decisions. In addition, the chapter makes clear that great diversity exists within Protestant thought. However, the section would be more faithful to reality if it added more chapters on Christianity, especially giving more space to the explanation of evangelical perspectives distinct from more liberal Protestant denominations. In fact, a chapter combining conservative evangelical and Catholic perspectives might shed more light on the issues since Catholics and evangelicals often find themselves with similar bioethical concerns. This is not so much a problem with the authors of these chapters as with the overall organization of the section. The way the section is divided, how much space is allocated to different perspectives, and the way the more complicated perspectives are explained needs more work.
Overall, this book serves as a helpful resource for pastors and theological students. It has its place on a reference shelf for consultation on specific issues that come up in ministry. The full index makes navigating the sixty-five chapters and ten sections fairly easy. Professors teaching courses on bioethics could also assign it to broaden students’ understanding of various issues, and the case studies in the individual chapters could prove fruitful for theological and pastoral reflection in the classroom. Although the book’s treatment of religion and theology leaves much to be desired, it still serves as an important resource for engagement with this increasingly complex field.