Review

The moral maybes

ETHICS AND VALUES IN HEALTH CARE MANAGEMENT
Souzy Dracopoulou (ed)
Routledge, 1998

This book explores the place of ethics in health care management. It examines the arguments of two opposing camps: those who believe that health care management can and should be underpinned by moral principles, even if these reflect the ethics of business and the pursuit of efficiency; and, conversely, those who see any relationship between ethics and health care managers as fundamentally problematic, if not impossible.

Case studies from Poland, Greece and France offer accounts of how ethics has or has not been reflected in the health care provision of these countries.

I was certainly challenged by the views in this book, which range from an argument for a set of universal principles which define standards of correctness and incorrectness, to the view that in our post-modern world the construction of rational solutions to social problems is problematic, and possibly an essentially elusive task.

Reading it certainly gives a good grounding in the theoretical and philosophical arguments which surround the role of ethics in healthcare management.

But as the editor notes, despite economies constantly being demanded from, and delivered by those who manage health care, there is a lack of empirical studies on ethics in healthcare management. This is not the role of this book, but perhaps the theoretical and philosophical debate so eruditely argued in these chapters could be furthered by empirical studies which look at what health care managers actually do in the pursuit of efficiency and effectiveness, and the role which ethics plays in that process.