Insistent Life consists of two distinct sections. In the first, Donaldson and Bajzelj give an overview of Jain philosophy and cosmology, paying special attention to the ethical reasoning present in canonical texts. In the second, Donaldson and Bajzelj present and discuss data gathered from a survey of Jain medical professionals who were asked about various controversial issues in contemporary bioethics. 

Section I is generally successful. The philosophical systems in question are described in considerable detail, but always thoroughly explained and clearly tied to their textual sources. One aspect of this discussion was especially resonant: because Jain cosmology describes a universe teeming with  many different types of lifeforms (humans, plants, animals, water-bodied, air-bodied, fire-bodied, and earth-bodied, seeds and particles, heavenly beings, hell beings, and so on), it is deemed impossible to live in the day-to-day world without committing violence and thereby accruing karma (believed to be a physical substance). Ultimately, this means that Jain mendicants on the path towards escaping samsara should gradually withdraw from this world and eventually from purposeful action itself. However, for lay Jains, the impossibility of fully practicing the value of ahimsa (nonviolence) means that careful decisions must be made to minimize and restrain one's violence in the present lifetime, while retaining ahimsa as an aspirational principle undergirding lives of admitted imperfection. Notably, different commitments may be taken by different laypeople (or different mendicants!) based on what is reasonable in each person's position. I feel quite similarly about the harm that is done in the course of human life and consumption, and the need to maintain an ethically-exacting awareness of these harms while also accommodating lived imperfection and diverging capacities for action. 

Section II was interesting but somewhat less useful, in my judgement. Donaldson and Bajzelj are to be commended for bringing these two distinct methodologies together. However, because contemporary western bioethical frameworks and concerns don't neatly map to the Jain frameworks described in Section I, it is not always clear what to make of the survey responses presented. Gathering these responses was surely of some usefulness to the field, but for generalist readers, a greater emphasis on qualitative reflections from these respondents may have yielded more insight and driven more productive conversation. In short, I was dissatisfied with the methodology of Section II, and found myself wishing that respondents had been interviewed, rather than surveyed.