Cambridge Quarterly of Healthcare Ethics

Book Review

Limits—The Role of the Law in Bioethical Decision Making, by Roger B. Dworkin. Bloomington (IN): Indiana University Press, 1996. 205 pp.

Ben A. Rich a1
a1 Department of Preventive Medicine and Biometrics, and the Program in Health Care Ethics, Humanities, and Law at the University of Colorado Health Sciences Center, Denver, Colorado


Anyone with so much as a passing familiarity with bioethics knows how significantly and persistently (at least since mid-century) the law has insinuated itself into healthcare and the process of bioethical decisionmaking. Viewed from the insular perspective of traditional medical practice and medical ethics, it is not surprising that the “legalization” of the patient–physician relationship and clinical judgment has been characterized by some as pernicious. What is much more surprising, however, is when a book by a professor of law evinces the same jaundiced view of the role of law in this area. Nonetheless, the “limits” that Professor Dworkin considers to be inherent in the capacity of the law to resolve bioethical issues are significant, and hence in his opinion the role of the law should be severely circumscribed. This gloomy portrait of the “havoc” wreaked by law upon the landscape of medical practice, painted by a lawyer, stands in stark contrast to an earlier and much more sympathetic account offered by Columbia University historian and medical humanities professor David J. Rothman in his 1991 book Strangers at the Bedside, the informative subtitle of which is A History of How Law and Bioethics Transformed Medical Decision Making.