Book Review Title: Cochlear Implants in Children: Ethics and Choices Authors: John B. Christiansen & Irene W. Leigh Publisher: Gallaudet University Press, 2002 Cost: $49.95, hardcover ISBN: 1-56368-116-1 Title: Ethics in Mental Health and Deafness Author: Virginia Gutman (editor) Publisher: Gallaudet University Press, 2002 Cost: $65.00, hardcover ISBN: 1-56368-120-X Reviewer: Simo Vehmas These two recent books treat ethical issues of immense importance related to working with deaf clients in mental health practice, and to the facts and controversies associated with cochlear implants. The titles of these books may be misleading though since the actual ethical discussion found in these books is scarce and shallow. The focus regarding ethics in these books is very practical. They deal with issues that professionals, parents and deaf people themselves may confront in different stages of life. In both books the ethics part is more an introduction to various ethical questions, rather than scrutinizing them and finding sound bases for ethical judgments. The authors do not discuss the issues philosophically. Gutman, for example, mentions in Ethics in Mental Health and Deafness, that her focus is not on providing the Òright answersÓ but on helping readers ask the right questions leading to ethically sound clinical decisions (p. 12). This may reflect a conscious methodological approach to examining ethics where the point is to enlighten moral philosophical reasoning to people unfamiliar with it. But presenting questions in itself is not very helpful if they are not discussed properly. To help readers make their own conclusions, one should provide them with arguments of the strengths and weaknesses of various possible normative judgments. In this sense, the ethical argument in Ethics in Mental Health and Deafness seems to cease before it has even properly begun. Christiansen and Leigh fortunately present the ethical dimensions related to cochlear implants in a more versatile manner. They provide readers with at least one possible tool for solving ethical problems: the four-principles approach developed by Tom Beauchamp and James Childress. However, the principles of autonomy, justice, beneficence and nonmaleficence do not in any manner constitute an unproblematic, indisputable foundation for resolving ethical dilemmas. The theory of four principles has been strongly criticized. Whether one finds it plausible is not the issue. The ideal in books like Cochlear Implants in Children is to give readers alternative ways to solve ethical issues. When only one philosophical tool is presented, the ethical reasoning is limited. Thus, from the viewpoint of philosophical ethics, these books do not seem to have too much to offer. However, one crucial element in applied ethics is the consideration of empirical knowledge. The use of empirical data gives a framework to the normative arguments and directs the conclusions. In this sense, these books provide some invaluable material to both academics and lay people. Many academics and professionals may not have even thought about many of the issues related to cochlear implants, deaf people in mental health care, the Deaf culture and so on. Regarding the awareness of the ethical issues related to deafness, these books give a useful overview of the field (this applies especially to Cochlear Implants in Children). Since many professionals, like the general public, do not have much time for complicated philosophical arguments, these books may be very useful to parents and professionals who have not encountered deafness and the related ethical issues. Simo Vehmas, Ph.D. in Education, specializes in ethical issues related to disability. The subjects of his publications include practical topics such as the morality of selective abortion, as well as more general theorization about the concept of disability. He may be contacted at Dept. of Moral and Social Philosophy, PO Box 9, 00014 University of Helsinki, Finland, or simo.vehmas@helsinki.fi; njet.net/users/vehmas