Choice Review

Residents of nursing homes spend the majority of their time living in the facility, rather than dying. However, most books on health care ethics and the elderly focus on end-of-life issues, such as "do not resuscitate," living wills, and cessation of nutrition and hydration. To fill the gap, two nationally known authors, Caplan (bioethics) and Kane (gerontology), have produced a readable book that addresses the ethical dilemmas surrounding day-to-day life in a nursing home. Personal autonomy is the theme woven throughout each of 18 cases that embody the core of the text. The cases examine issues such as room selection, phone use, mealtimes, bathing, mobility, and tipping. Each case is ethically analyzed by one of a distinguished, multidisciplinary group of contributors. The case discussions emphasize what is "ethically appropriate," and also the barriers, such as regulations and scarce resources, that preclude attaining what is appropriate. Additional chapters discuss the reality of life in a nursing home, and present recommendations for reorganizing the nursing service to promote resident autonomy. A particular strength is emphasis on the role and viewpoint of the nursing aide, the primary caregiver in this setting. Brief chapter bibliographies. This seminal work is an excellent resource. Highly recommended for community college through graduate collections. -M. A. Thompson, Saint Joseph College