Ellen Bernal

The intellectual history of Healthcare Ethics Consultation embraces objectivism and its emphasis on knowledge that has already been achieved. As a result, official descriptions, standards, and guidelines for this practice, while valuable, ordinarily exclude consideration of the ethics consultant in the process of knowing. Narratives of complex cases, including those that have led to perceived errors, are signs that point to Michael Polanyi’s notion of personal knowledge. The writings of Polanyi, Maurice Merleau-Ponty, and William H. Poteat support a paradigm shift to “post-critical thinking,” opening new avenues for ethics consultation teaching and learning, particularly in the setting of clinical internships.

Michael Polanyi’s thought still has an “outsider” status, despite the efforts of The Polanyi Society and extensive publications by other scholars in various fields. Gulick attributes this limited familiarity to Polanyi’s complexity and atypical philosophical insights, his re-introduction of the personal in feats of knowing, and his call for significant intellectual reform. Gulick sets out to remedy the situation with his well written, comprehensive, and accessible anthology. Polanyi’s thought can be applied to many of today’s concerns, including human research, animal intelligence, ecoliterature, and socio-political problems. Gulick’s book is an excellent resource for introducing students and others to the relevance of Polanyi’s thought for today’s issues.

Hysterectomy (or hysterectomy with oophorectomy) is the most frequently performed major surgery in the United States, affecting approximately 700,000 women each year (Easterday, 1983). There has long been interest in the psychological effects of these surgeries. However, apart from the concern that some hysterectomies may be unnecessary (Pearse, 1976), there has been little attention to bioethical issues relating to hysterectomy. Physicians and nurses are ethically obligated to respect the woman who may have a hysterectomy by treating her as an autonomous agent. Informed consent within the context of a decision for hysterectomy should include balanced information and supportive exploration of the woman's values, goals, and life plan. Care of the patient should assist her adjustment, thereby also promoting her autonomy. Physician attitudes toward hysterectomy and the hysterectomy patient can have a major influence on patient self-determination.