BOOK REVIEW / CRITIQUE DE LIVRE

**Biomedical organizations: A worldwide guide to position documents.** By Dale A. Stirling. New York: Haworth Press, 2006. 302 pages. ISBN 978-0-7890-2297-4 (hard cover). US$49.95. ISBN 978-0-7890-2298-1 (soft cover). US$34.95.

The modern world, propelled by commercial, political, and legal interests and protocols, increasingly demands organizations to establish transparent agendas. Publicly and readily accessible position statements and policy documents help answer this demand. In the biomedical field, morality and ethics figure prominently, requiring even more transparency and guidance from our organizations. Stirling's reference index facilitates access to this specific body of collective thought and opinion.

The author states in the preface that “the basic purpose of this book is to identify what biomedical organizations were thinking about in the early 21st century”. The daily news tells us what to think “about”; don’t we conversely want to know what the organization actually thinks — its collective position or opinion on the burning issues? Indeed, little study has been made of the “position statement”, and therefore, we welcome the book’s treatise on the subject, however short. Unfortunately, 99% of this title consists of lists: lists of the names and homepage URLs of biomedical organizations, position statement titles, and the index. This type of content becomes outdated very quickly.

The efforts of Stirling, who is also a researcher and consultant on environmental and public health issues, in producing this unique, labour-intensive work is commendable. However, its use beyond that of a handy index may be limited. More thanks could be garnered if this work were to graduate to an electronic database that included hyperlinks, regular updating and archiving, and the capacity to retrieve the actual documents. In 2003 the author himself reviewed a CD-ROM companion product to a similar reference work. He stated that what made the work so valuable was the added capacity of the CD-ROM, namely the hyperlinks and the documents in PDF format. Perhaps Stirling will take his own advice in a second edition of this publication.

Annotations and a good index would also have been helpful. Indexing is key to the success of any research tool and taxonomy is key to indexing. The numerous inconsistencies and errors noted in the index suggest that a more thorough effort was needed. For instance, “euthanasia” appears as an entry while “assisted suicide” sends the reader to “physician-assisted suicide”, which is cross-referenced with “suicide”; none of these later terms connects the reader to the first. The National Community Pharmacists Association

has a position statement entitled “Homeopathy”, yet I was unable to find any reference to it in the index even under the more general term of “complementary & alternative medicine” or CAM. The American Society of Clinical Oncology’s policy on “CAM therapies” was not indexed under “CAM”, and its policy on “genetic testing” was not indexed under “genetics”. The Canadian Nurses Association has a listed, but not indexed, position statement on “human rights”.

The author claims no geographical boundaries were imposed when compiling the list, hence the term “worldwide” in the title. Yet the simple choice of search engines and Internet indexes relied on for the selection process does affect the scope, as does the choice to limit references to English language sources. The odd topic strays beyond the medical field with the inclusion of apartheid and corporal punishment. All in all, of the stated 4000 qualifying organizations in existence, 1000 are not only represented in this work but their Web sites were scoured and half were contacted for further verification. Forty-seven Canadian organizations are included.

The disappointing 30% response rate during the verifying of information may have led the author to include an appendix that lists those organizations that purportedly and surprisingly don't have position documents! I question the wisdom of including such a list in a work that is attempting to capture a moving target, within a relatively new and largely American “genre”, aspiring to global parameters. Noting one correction, the Canadian Dental Association does indeed have Internet accessible position statements that are reviewed and readopted or revised on a regular basis.

The author's opinion is that developing position statements is part of an organization's quest for legitimacy and "cache". In our highly politicized and frequently demoralized world, I would suggest the impetus stems from simple political positioning, garnering legal protection (an elaborate disclaimer), or from a will to provide leadership while contributing to scholarship.

Because of the work's limitations in content and format, its value remains marginal today, and I seriously question its historical utility going forward.

Ann Celestine

International University of Nursing

P.O. Box 1218

Basseterre, Saint Kitts and Nevis, West Indies

E-mail: acelestine@iuon.net
<figure><img src="image_1.png" /></figure>