Ethics books can be divided conveniently into those that are top-down and those that are bottom-up. The top-down books begin with an ethical theory and try to use the theory to sort out practical ethical problems. A good example of this type of book is Beauchamp and Childress's Principles of Biomedical Ethics, which applies the 'four principles' to a range of ethical cases. Conversely, bottom-up books begin with the ethical problem and try to make sense of it. This approach seems right - clinical practice is too messy to be squeezed obligingly into a ready-made theory .
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