Children in precarious health present particular problems for healthcare professionals because of their intimate relation to their family, and because of the family's need to provide major long-term source of support and to be actively involved in the decisions about their children's care. This collection of cases and commentaries in pediatrics highlights the difficult ethical dilemmas that can arise during high-tech hospital care of children in precarious circumstances. It serves as a teaching tool for clinical ethics and as an introduction for medical students and residents. Clinical cases are described in detail by the physicians involved, who focus on the ethical issues arising during treatment. Each case is then commented on in detail by a philosopher or other bioethicist. It thus serves well as an introduction to contemporary clinical bioethics, but with a firm grounding in the practicalities of real-life pediatric care in the hospital setting.

The essays in Where's the Evidence? focus on problems ignored. This book is a unique collection of critical andw controversial essays on intractable ethical issues and evidence-based problems in modern medicine. Most, but notr therapeutic disasters. Although it is impossible to prevent all missteps in medicine, the author argues, a hedging strategy using concurrent controls when new therapies are introduced always reduces the number of patients killed or injured. It is dangerous to use treatments widely, he warns, before they are subject to rigorous comparative trials. Additionally, the author points out, questions have emerged about how to wield medicine's new capabilities wisely. How do we draw the line,' he asks 'between "knowing" (the acquisition of new medical information) and "doing" (the application of that new knowledge). What are the long- term consequences (moral, social, economic, and biological) of responding to a demand that medicine always do everything that can be done?' This book now issued in paperback is a collection of critical and controversial essays discussing intractable ethical issues and evidence-based problems in modern medicine. The essays together with responses were published over a ten-year period in the journal Paediatric and Perinatal Medicine. Most of the examples, but not all are taken from perinatal medicine, the field in which the author has worked for many years. The essays are thought provoking and will be of great interest to those involved in the ongoing evidence-based medicine debate. (See selected reviews)