and Ventilation Accessories’ and ‘Managing Equipment and Supply Needs in the Home’, respectively, describe in-depth the state of the art equipment and accessories as well as costs and specific manufacturers along with their addresses.

In addition to being up-to-date and well documented, this book has other strengths. It contains numerous tables, tools, and pictures which illustrate the content in a concise manner and provide supplementary information. The text is well organized taking the reader from defining the ventilator-dependent patient through assessing readiness for discharge to the financial planning involved in the home care of the ventilator-dependent patient.

Several limitations unfortunately weaken the overall impact of this book. The superb and thorough discharge teaching and planning as outlined in this book contrasts sharply with the abbreviated description of community resources, particularly the area dealing with home health care agencies as discussed in Chapter 10 ‘Community Resources’. The text points out that discharging a patient to home is not possible without the involvement of home care agencies, yet does not give any in-depth information regarding such agencies. Contrary to the author’s statement, many community agencies are indeed currently involved in high technology nursing such as intravenous therapy, hyperalimintation therapy, and tracheostomy care with continuous oxygen within the home setting.

A second limitation of this text is in the area of specific costs of equipment and supplies. While this information would be useful to the potential buyer, varying costs and changing prices will quickly lead to the outdating of this information.

The authors indicate that this book would be useful to health care personnel involved in caring for a ventilator-assisted patient. It would also be an excellent resource for students in respiratory therapy and for patients requiring ventilator assistance and their families and/or caregivers.

Betty J. Bristol, R.N., M.S.N. Staff Nurse

Hospital Based Home Care Veterans Administration Medical Center

Washington, DC 20422, U.S.A.

The Patient as Partner, Robert M. Veatch, Bloomington, IN: Indiana University Press, 1987.

This book is a collection of essays by the well-known ethicist, Robert Veatch who authored, Case Studies in Medical Ethics, and A Theory of Medical Ethics. The specific focus of this book is an assessment of the implications of considering the research subject patient as a partner in medical experimentation. The author argues that this framework differs from the

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traditional view of the human research subject patient as ‘Research Material or a ‘Patient’ in the passive sense of the word.

Sixteen chapters of The Patient as Partner are adaptations of essays previously published by the author between 1971 and 1983. Three chapters are original; ‘Beneficence as the Minimal Justification for Research’, ‘The Use of Lay Surrogates to Decide How Much Information should be Transmitted in Informed Consent’, and the concluding chapter.

This book gains much strength as a single resource for those who wish to examine human experimentation from an ethical perspective. First, Veatch probes such fundamental ethical issues as the concept of beneficence, the principle of autonomy and the role of justice in research design in clear, self- contained chapters. He then proceeds to explore the impact of federal regulations on biomedical research. He examines such central subjects as the power, authority and legitimacy of federal laws and succinctly summarizes some progress and problems experienced by the IRBS. He closes by describing some selected controversial areas, including the complexities of experimentation with oral contraceptives, research on teenagers, research on the brain-dead, risk-taking in cancer chemotherapy, and ethics concerning research in radiation.

From the perspective of counseling and patient education the strength of the book lies in its ability to suggest and argue for a fresh outlook on the complex relationship between patients and physician-scientists. Veatch hopes that in this way, ethical issues of medical research can be addressed and resolved, rather than simply by continuing the construction of new lists of rules to eliminate the more obvious abuses. Veatch argues that in clinical research there is an implicit convergence of interests where both researcher and subject have something to gain by participating and where each is called upon to make some sacrifice for the benefit of the other. Rather than the traditional adversarial approach of individual patient rights versus the rights of society, Veatch contends that these are the makings of a true partnership. He argues convincingly for the use of the concept of partnership as the foundation for an ethics of research.

The weakest point of the book lies simply in the effect of selecting articles from 1971- 1983, which preclude the opportunity for Veatch to address such current issues as AIDS or third-party payment for experimental research. The next edition of this book, however, may well include a thoughtful review of these ethical dilemmas. In summary this is a very useful resource for anyone interested involved in human experimentation, whether as patient, physician or research organizer.

Kathryn Taylor, P.D. Assistant Professor

Department of Behavioural Science University of Toronto

Toronto, Ontario Canada

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