The Social Medicine Reader
Herausgeber: Henderson, Gail E; Churchill, Larry R; Estroff, Sue E; Strauss, Ronald P; King, Nancy M P
The Social Medicine Reader
Herausgeber: Henderson, Gail E; Churchill, Larry R; Estroff, Sue E; Strauss, Ronald P; King, Nancy M P
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"A wonderful collection that in its impressive breadth and depth gives a full account of a nation's contemporary medicine as it has been shaped by the events of the late 20th century."--Robert Coles
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"A wonderful collection that in its impressive breadth and depth gives a full account of a nation's contemporary medicine as it has been shaped by the events of the late 20th century."--Robert Coles
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Hinweis: Dieser Artikel kann nur an eine deutsche Lieferadresse ausgeliefert werden.
Produktdetails
- Produktdetails
- Verlag: Duke University Press
- Seitenzahl: 528
- Erscheinungstermin: 2. Juni 1997
- Englisch
- Abmessung: 255mm x 180mm x 32mm
- Gewicht: 1039g
- ISBN-13: 9780822319658
- ISBN-10: 0822319659
- Artikelnr.: 21480502
- Herstellerkennzeichnung
- Libri GmbH
- Europaallee 1
- 36244 Bad Hersfeld
- 06621 890
- Verlag: Duke University Press
- Seitenzahl: 528
- Erscheinungstermin: 2. Juni 1997
- Englisch
- Abmessung: 255mm x 180mm x 32mm
- Gewicht: 1039g
- ISBN-13: 9780822319658
- ISBN-10: 0822319659
- Artikelnr.: 21480502
- Herstellerkennzeichnung
- Libri GmbH
- Europaallee 1
- 36244 Bad Hersfeld
- 06621 890
Gail E. Henderson, Nancy M. P. King, Ronald P. Strauss, Sue E. Estroff, and Larry R. Churchill, eds.
Preface ix
Introduction 1
Part I. A Cultural Perspective of Experiences of Illness, Disability, nd
Deviance
Introduction / Sue Estroff 6
1. Culture, Health, and Illness 12
The Nature of Suffering and the Goals of Medicine / Eric J. Cassell 13
Cancer, Control, and Causality: Talking about Cancer in a Working-Class
Community / Martha Belshem 23
Coming to Terms with Advanced Breast Cancer: Black Women's Narratives from
Eastern North Carolina / Holly F. Matthews, Donald R. Lannin, and James P.
Mitchell 43
2. Illness Experiences and Illness Narratives 61
The Deer at Providencia / Annie Dillard 63
The Cost of Appearances / Arthur Frank 66
Silver Water / Amy Bloom 69
3. Experiences of Deviance, Chronic Illness, and Disability 75
Self, Identity, and the Naming Question: Reflections on the Language of
Disability / Irving Kenneth Zola 77
Finch the Spastic Speaks / Gordon Weaver 87
Tell Me, Tell Me / Irving Kenneth Zola 95
Part II. The Influence of Social Factors on Health and Illness
Introduction / Gail E. Henderson 100
1. The Relationship between Social Class, Race/Ethnicity, and Health 108
Socioeconomic Inequalities in Health: No Easy Solution / Nancy E. Adler 109
"Where Crowded Humanity Suffers and Sickens": The Banes Family and Their
Neighborhood / Laurie K. Abraham 121
One Drop of Blood / Lawrence Wright 131
2. Gender and Health 142
Women Have Headaches, Men Have Backaches: Patterns of Illness in an
Appalachian Community / Claire F. Horton 143
Spence + Lila (excerpts) / Bobbie Ann Mason 156
The Mother-in-Law / Doris Betts 163
3. Old Age 167
Trends, Issues, Perspectives, and Values for the Aging of the Baby Boom
Cohorts (excerpts) / John M. Cornman and Eric R. Kingson 168
What Do Children Owe Elderly Parents? / Daniel Callahan 175
Decision Making, Responsibility, and Advocacy in Geriatric Medicine:
Physician Dilemmas with Elderly in the Community / Sharon R. Kaufman 184
We Are Nighttime Travelers / Ethan Canin 196
Part III. The Culture of Medicine and Medical Practice
Introduction / Ronald P. Strauss 205
The Socialization of Physicians 209
Basic Clinical Skills: The First Encounters / Melvin Konner 210
Becoming a Doctor: Critical-Incident Reports from Third-Year Medical
Students / William Branch, Richard J. Pels, Robert S. Lawrence, and Ronald
Arky 223
Invasions / Perri Klass 227
Ethical Dilemmas fro House Staff Physicians: The Care of Critically Ill and
Dying Patients / William Winkenwerder Jr. 230
A Student's View of a Medical Teaching Exercise / Abenaa Brewster 236
The Libby Zion Case: One Step Forward or Two Steps Backward? / David A.
Asch and Ruth M. Parker 238
2. Medical Practice in Social Context 244
Presidential Address: The Boundaries of Medicine / Donald W. Seldin 244
The Boundaries of Medicine / Gerald T. Perkoff 254
The Changing Demography of the Medical Profession / Arnold S. Relman 263
Medicine is No Longer a Man's Profession: Or, When the Men's Club Goes Coed
It's Time to Change the Regs / Carola Eisenberg 266
The Doctors of Hoyland / Sir Arthur Conan Doyle 270
3. Relationships between Doctors and Patients 277
The Basic Models of the Doctor-Patient Relationship / Thomas S. Szasz and
Marc H. Hollender 278
Facing Our Mistakes / David Hilfiker 287
Simple Living and Hard Choices / Maureen A. Flannery 293
The Paid Nurse / William Carlos Williams 300
Part IV. Health Care Ethics and the Provider's Role
Introduction / Nancy M. P. King 304
1. The Provider-Patient Relationship 309
Bioethics in Social Context / Larry R. Churchill 310
The Use of Force / William Carlos Williams 320
Case Study: The "Student Doctor" and a Wary Patient / Marc D. Basson,
Gerald Dworkin, and Eric J. Cassell 323
Truth Telling to the Patient / Antonella Surbone 326
Is Truth Telling to the Patient a Cultural Artifact? / Edmund D. Pellegrino
330
Offering Truth: One Ethical Approach to the Uninformed Cancer Patient /
Benjamin Freedman 333
What the Doctor Said / Raymond Carver 341
Informed Consent, Cancer, and Truth in Prognosis / George J. Annas 341
Swapping Stories: A Matter of Ethics / Judith Andre 346
Case Study: Please Don't Tell / Leonard Fleck and Marcia Angell 349
2. Interests in Conflict 353
Cesareans and Samaritans / Nancy K. Rhoden 354
Justified Limits on Refusing Intervention / Frank A. Chervenak and Laurence
B. McCullough 365
Faith (Healing), Hope, and Charity at the FDA: The Politics of AIDS Drug
Trials / George J. Annas 375
Case Study: The Doctor's Unproven Beliefs and the Subjects Informed Choice
/ Don Marquis 386
3. Choices about Treatment 391
Disconnecting a Ventilator at the Request of a Patient Who Knows He Will
Then Die: The Doctor's Anguish / Miles J. Edwards and Susan W. Tolle 393
The Last Words of My English Grandmother / William Carlos Williams 398
Death and Dignity: A Case of Individualized Decision Making / Timothy E.
Quill 399
Informed Demand for "Non-Beneficial" Medical Treatment / Steven H. Miles
403
The Case of Helga Wanglie: A New Kind of "Right to Die" Case / Marcia
Angell 407
Part V. Medical Care Financing, Rationing, and Managed Care
Introduction / Larry R. Churchill 410
1. Medical Care Financing 415
Paying for Medical Care in America / Donald L. Madison 415
Reforming the Health Care System: The Universal Dilemma / Uwe E. Reinhardt
446
2. Rationing: The Dilemmas of Fair Distribution 460
The "Rationing" of Medical Care / Victor R. Fuchs 461
The Prostitute, the Playboy, and the Poet: Rationing Schemes for Organ
Transplantation / George J. Annas 464
Ethics of Queuing for Coronary Artery Bypass Grafting in Canada / Jafna L.
Cox 469
Rationing in Practice: The Case of In Vitro Fertilisation / Sharon Redmayne
and Rudolf Klein 475
3. Managed Care and the Physician's Changing Role 481
Hippocrates and the Health Maintenance Organization: A Discussion of
Ethical Issues / Gail Povar and Jonathan Moreno 482
Physicians and Business Managers: A Clash of Cultures / Arnold S. Relman
491
Preserving the Physician-Patient Relationship in the Era of Managed Care /
Ezekiel J. Emanuel and Nancy Neveloff Dubler 495
Bibliography 510
Acknowledgment of Copyrights 514
Index to Authors 517
Introduction 1
Part I. A Cultural Perspective of Experiences of Illness, Disability, nd
Deviance
Introduction / Sue Estroff 6
1. Culture, Health, and Illness 12
The Nature of Suffering and the Goals of Medicine / Eric J. Cassell 13
Cancer, Control, and Causality: Talking about Cancer in a Working-Class
Community / Martha Belshem 23
Coming to Terms with Advanced Breast Cancer: Black Women's Narratives from
Eastern North Carolina / Holly F. Matthews, Donald R. Lannin, and James P.
Mitchell 43
2. Illness Experiences and Illness Narratives 61
The Deer at Providencia / Annie Dillard 63
The Cost of Appearances / Arthur Frank 66
Silver Water / Amy Bloom 69
3. Experiences of Deviance, Chronic Illness, and Disability 75
Self, Identity, and the Naming Question: Reflections on the Language of
Disability / Irving Kenneth Zola 77
Finch the Spastic Speaks / Gordon Weaver 87
Tell Me, Tell Me / Irving Kenneth Zola 95
Part II. The Influence of Social Factors on Health and Illness
Introduction / Gail E. Henderson 100
1. The Relationship between Social Class, Race/Ethnicity, and Health 108
Socioeconomic Inequalities in Health: No Easy Solution / Nancy E. Adler 109
"Where Crowded Humanity Suffers and Sickens": The Banes Family and Their
Neighborhood / Laurie K. Abraham 121
One Drop of Blood / Lawrence Wright 131
2. Gender and Health 142
Women Have Headaches, Men Have Backaches: Patterns of Illness in an
Appalachian Community / Claire F. Horton 143
Spence + Lila (excerpts) / Bobbie Ann Mason 156
The Mother-in-Law / Doris Betts 163
3. Old Age 167
Trends, Issues, Perspectives, and Values for the Aging of the Baby Boom
Cohorts (excerpts) / John M. Cornman and Eric R. Kingson 168
What Do Children Owe Elderly Parents? / Daniel Callahan 175
Decision Making, Responsibility, and Advocacy in Geriatric Medicine:
Physician Dilemmas with Elderly in the Community / Sharon R. Kaufman 184
We Are Nighttime Travelers / Ethan Canin 196
Part III. The Culture of Medicine and Medical Practice
Introduction / Ronald P. Strauss 205
The Socialization of Physicians 209
Basic Clinical Skills: The First Encounters / Melvin Konner 210
Becoming a Doctor: Critical-Incident Reports from Third-Year Medical
Students / William Branch, Richard J. Pels, Robert S. Lawrence, and Ronald
Arky 223
Invasions / Perri Klass 227
Ethical Dilemmas fro House Staff Physicians: The Care of Critically Ill and
Dying Patients / William Winkenwerder Jr. 230
A Student's View of a Medical Teaching Exercise / Abenaa Brewster 236
The Libby Zion Case: One Step Forward or Two Steps Backward? / David A.
Asch and Ruth M. Parker 238
2. Medical Practice in Social Context 244
Presidential Address: The Boundaries of Medicine / Donald W. Seldin 244
The Boundaries of Medicine / Gerald T. Perkoff 254
The Changing Demography of the Medical Profession / Arnold S. Relman 263
Medicine is No Longer a Man's Profession: Or, When the Men's Club Goes Coed
It's Time to Change the Regs / Carola Eisenberg 266
The Doctors of Hoyland / Sir Arthur Conan Doyle 270
3. Relationships between Doctors and Patients 277
The Basic Models of the Doctor-Patient Relationship / Thomas S. Szasz and
Marc H. Hollender 278
Facing Our Mistakes / David Hilfiker 287
Simple Living and Hard Choices / Maureen A. Flannery 293
The Paid Nurse / William Carlos Williams 300
Part IV. Health Care Ethics and the Provider's Role
Introduction / Nancy M. P. King 304
1. The Provider-Patient Relationship 309
Bioethics in Social Context / Larry R. Churchill 310
The Use of Force / William Carlos Williams 320
Case Study: The "Student Doctor" and a Wary Patient / Marc D. Basson,
Gerald Dworkin, and Eric J. Cassell 323
Truth Telling to the Patient / Antonella Surbone 326
Is Truth Telling to the Patient a Cultural Artifact? / Edmund D. Pellegrino
330
Offering Truth: One Ethical Approach to the Uninformed Cancer Patient /
Benjamin Freedman 333
What the Doctor Said / Raymond Carver 341
Informed Consent, Cancer, and Truth in Prognosis / George J. Annas 341
Swapping Stories: A Matter of Ethics / Judith Andre 346
Case Study: Please Don't Tell / Leonard Fleck and Marcia Angell 349
2. Interests in Conflict 353
Cesareans and Samaritans / Nancy K. Rhoden 354
Justified Limits on Refusing Intervention / Frank A. Chervenak and Laurence
B. McCullough 365
Faith (Healing), Hope, and Charity at the FDA: The Politics of AIDS Drug
Trials / George J. Annas 375
Case Study: The Doctor's Unproven Beliefs and the Subjects Informed Choice
/ Don Marquis 386
3. Choices about Treatment 391
Disconnecting a Ventilator at the Request of a Patient Who Knows He Will
Then Die: The Doctor's Anguish / Miles J. Edwards and Susan W. Tolle 393
The Last Words of My English Grandmother / William Carlos Williams 398
Death and Dignity: A Case of Individualized Decision Making / Timothy E.
Quill 399
Informed Demand for "Non-Beneficial" Medical Treatment / Steven H. Miles
403
The Case of Helga Wanglie: A New Kind of "Right to Die" Case / Marcia
Angell 407
Part V. Medical Care Financing, Rationing, and Managed Care
Introduction / Larry R. Churchill 410
1. Medical Care Financing 415
Paying for Medical Care in America / Donald L. Madison 415
Reforming the Health Care System: The Universal Dilemma / Uwe E. Reinhardt
446
2. Rationing: The Dilemmas of Fair Distribution 460
The "Rationing" of Medical Care / Victor R. Fuchs 461
The Prostitute, the Playboy, and the Poet: Rationing Schemes for Organ
Transplantation / George J. Annas 464
Ethics of Queuing for Coronary Artery Bypass Grafting in Canada / Jafna L.
Cox 469
Rationing in Practice: The Case of In Vitro Fertilisation / Sharon Redmayne
and Rudolf Klein 475
3. Managed Care and the Physician's Changing Role 481
Hippocrates and the Health Maintenance Organization: A Discussion of
Ethical Issues / Gail Povar and Jonathan Moreno 482
Physicians and Business Managers: A Clash of Cultures / Arnold S. Relman
491
Preserving the Physician-Patient Relationship in the Era of Managed Care /
Ezekiel J. Emanuel and Nancy Neveloff Dubler 495
Bibliography 510
Acknowledgment of Copyrights 514
Index to Authors 517
Preface ix
Introduction 1
Part I. A Cultural Perspective of Experiences of Illness, Disability, nd
Deviance
Introduction / Sue Estroff 6
1. Culture, Health, and Illness 12
The Nature of Suffering and the Goals of Medicine / Eric J. Cassell 13
Cancer, Control, and Causality: Talking about Cancer in a Working-Class
Community / Martha Belshem 23
Coming to Terms with Advanced Breast Cancer: Black Women's Narratives from
Eastern North Carolina / Holly F. Matthews, Donald R. Lannin, and James P.
Mitchell 43
2. Illness Experiences and Illness Narratives 61
The Deer at Providencia / Annie Dillard 63
The Cost of Appearances / Arthur Frank 66
Silver Water / Amy Bloom 69
3. Experiences of Deviance, Chronic Illness, and Disability 75
Self, Identity, and the Naming Question: Reflections on the Language of
Disability / Irving Kenneth Zola 77
Finch the Spastic Speaks / Gordon Weaver 87
Tell Me, Tell Me / Irving Kenneth Zola 95
Part II. The Influence of Social Factors on Health and Illness
Introduction / Gail E. Henderson 100
1. The Relationship between Social Class, Race/Ethnicity, and Health 108
Socioeconomic Inequalities in Health: No Easy Solution / Nancy E. Adler 109
"Where Crowded Humanity Suffers and Sickens": The Banes Family and Their
Neighborhood / Laurie K. Abraham 121
One Drop of Blood / Lawrence Wright 131
2. Gender and Health 142
Women Have Headaches, Men Have Backaches: Patterns of Illness in an
Appalachian Community / Claire F. Horton 143
Spence + Lila (excerpts) / Bobbie Ann Mason 156
The Mother-in-Law / Doris Betts 163
3. Old Age 167
Trends, Issues, Perspectives, and Values for the Aging of the Baby Boom
Cohorts (excerpts) / John M. Cornman and Eric R. Kingson 168
What Do Children Owe Elderly Parents? / Daniel Callahan 175
Decision Making, Responsibility, and Advocacy in Geriatric Medicine:
Physician Dilemmas with Elderly in the Community / Sharon R. Kaufman 184
We Are Nighttime Travelers / Ethan Canin 196
Part III. The Culture of Medicine and Medical Practice
Introduction / Ronald P. Strauss 205
The Socialization of Physicians 209
Basic Clinical Skills: The First Encounters / Melvin Konner 210
Becoming a Doctor: Critical-Incident Reports from Third-Year Medical
Students / William Branch, Richard J. Pels, Robert S. Lawrence, and Ronald
Arky 223
Invasions / Perri Klass 227
Ethical Dilemmas fro House Staff Physicians: The Care of Critically Ill and
Dying Patients / William Winkenwerder Jr. 230
A Student's View of a Medical Teaching Exercise / Abenaa Brewster 236
The Libby Zion Case: One Step Forward or Two Steps Backward? / David A.
Asch and Ruth M. Parker 238
2. Medical Practice in Social Context 244
Presidential Address: The Boundaries of Medicine / Donald W. Seldin 244
The Boundaries of Medicine / Gerald T. Perkoff 254
The Changing Demography of the Medical Profession / Arnold S. Relman 263
Medicine is No Longer a Man's Profession: Or, When the Men's Club Goes Coed
It's Time to Change the Regs / Carola Eisenberg 266
The Doctors of Hoyland / Sir Arthur Conan Doyle 270
3. Relationships between Doctors and Patients 277
The Basic Models of the Doctor-Patient Relationship / Thomas S. Szasz and
Marc H. Hollender 278
Facing Our Mistakes / David Hilfiker 287
Simple Living and Hard Choices / Maureen A. Flannery 293
The Paid Nurse / William Carlos Williams 300
Part IV. Health Care Ethics and the Provider's Role
Introduction / Nancy M. P. King 304
1. The Provider-Patient Relationship 309
Bioethics in Social Context / Larry R. Churchill 310
The Use of Force / William Carlos Williams 320
Case Study: The "Student Doctor" and a Wary Patient / Marc D. Basson,
Gerald Dworkin, and Eric J. Cassell 323
Truth Telling to the Patient / Antonella Surbone 326
Is Truth Telling to the Patient a Cultural Artifact? / Edmund D. Pellegrino
330
Offering Truth: One Ethical Approach to the Uninformed Cancer Patient /
Benjamin Freedman 333
What the Doctor Said / Raymond Carver 341
Informed Consent, Cancer, and Truth in Prognosis / George J. Annas 341
Swapping Stories: A Matter of Ethics / Judith Andre 346
Case Study: Please Don't Tell / Leonard Fleck and Marcia Angell 349
2. Interests in Conflict 353
Cesareans and Samaritans / Nancy K. Rhoden 354
Justified Limits on Refusing Intervention / Frank A. Chervenak and Laurence
B. McCullough 365
Faith (Healing), Hope, and Charity at the FDA: The Politics of AIDS Drug
Trials / George J. Annas 375
Case Study: The Doctor's Unproven Beliefs and the Subjects Informed Choice
/ Don Marquis 386
3. Choices about Treatment 391
Disconnecting a Ventilator at the Request of a Patient Who Knows He Will
Then Die: The Doctor's Anguish / Miles J. Edwards and Susan W. Tolle 393
The Last Words of My English Grandmother / William Carlos Williams 398
Death and Dignity: A Case of Individualized Decision Making / Timothy E.
Quill 399
Informed Demand for "Non-Beneficial" Medical Treatment / Steven H. Miles
403
The Case of Helga Wanglie: A New Kind of "Right to Die" Case / Marcia
Angell 407
Part V. Medical Care Financing, Rationing, and Managed Care
Introduction / Larry R. Churchill 410
1. Medical Care Financing 415
Paying for Medical Care in America / Donald L. Madison 415
Reforming the Health Care System: The Universal Dilemma / Uwe E. Reinhardt
446
2. Rationing: The Dilemmas of Fair Distribution 460
The "Rationing" of Medical Care / Victor R. Fuchs 461
The Prostitute, the Playboy, and the Poet: Rationing Schemes for Organ
Transplantation / George J. Annas 464
Ethics of Queuing for Coronary Artery Bypass Grafting in Canada / Jafna L.
Cox 469
Rationing in Practice: The Case of In Vitro Fertilisation / Sharon Redmayne
and Rudolf Klein 475
3. Managed Care and the Physician's Changing Role 481
Hippocrates and the Health Maintenance Organization: A Discussion of
Ethical Issues / Gail Povar and Jonathan Moreno 482
Physicians and Business Managers: A Clash of Cultures / Arnold S. Relman
491
Preserving the Physician-Patient Relationship in the Era of Managed Care /
Ezekiel J. Emanuel and Nancy Neveloff Dubler 495
Bibliography 510
Acknowledgment of Copyrights 514
Index to Authors 517
Introduction 1
Part I. A Cultural Perspective of Experiences of Illness, Disability, nd
Deviance
Introduction / Sue Estroff 6
1. Culture, Health, and Illness 12
The Nature of Suffering and the Goals of Medicine / Eric J. Cassell 13
Cancer, Control, and Causality: Talking about Cancer in a Working-Class
Community / Martha Belshem 23
Coming to Terms with Advanced Breast Cancer: Black Women's Narratives from
Eastern North Carolina / Holly F. Matthews, Donald R. Lannin, and James P.
Mitchell 43
2. Illness Experiences and Illness Narratives 61
The Deer at Providencia / Annie Dillard 63
The Cost of Appearances / Arthur Frank 66
Silver Water / Amy Bloom 69
3. Experiences of Deviance, Chronic Illness, and Disability 75
Self, Identity, and the Naming Question: Reflections on the Language of
Disability / Irving Kenneth Zola 77
Finch the Spastic Speaks / Gordon Weaver 87
Tell Me, Tell Me / Irving Kenneth Zola 95
Part II. The Influence of Social Factors on Health and Illness
Introduction / Gail E. Henderson 100
1. The Relationship between Social Class, Race/Ethnicity, and Health 108
Socioeconomic Inequalities in Health: No Easy Solution / Nancy E. Adler 109
"Where Crowded Humanity Suffers and Sickens": The Banes Family and Their
Neighborhood / Laurie K. Abraham 121
One Drop of Blood / Lawrence Wright 131
2. Gender and Health 142
Women Have Headaches, Men Have Backaches: Patterns of Illness in an
Appalachian Community / Claire F. Horton 143
Spence + Lila (excerpts) / Bobbie Ann Mason 156
The Mother-in-Law / Doris Betts 163
3. Old Age 167
Trends, Issues, Perspectives, and Values for the Aging of the Baby Boom
Cohorts (excerpts) / John M. Cornman and Eric R. Kingson 168
What Do Children Owe Elderly Parents? / Daniel Callahan 175
Decision Making, Responsibility, and Advocacy in Geriatric Medicine:
Physician Dilemmas with Elderly in the Community / Sharon R. Kaufman 184
We Are Nighttime Travelers / Ethan Canin 196
Part III. The Culture of Medicine and Medical Practice
Introduction / Ronald P. Strauss 205
The Socialization of Physicians 209
Basic Clinical Skills: The First Encounters / Melvin Konner 210
Becoming a Doctor: Critical-Incident Reports from Third-Year Medical
Students / William Branch, Richard J. Pels, Robert S. Lawrence, and Ronald
Arky 223
Invasions / Perri Klass 227
Ethical Dilemmas fro House Staff Physicians: The Care of Critically Ill and
Dying Patients / William Winkenwerder Jr. 230
A Student's View of a Medical Teaching Exercise / Abenaa Brewster 236
The Libby Zion Case: One Step Forward or Two Steps Backward? / David A.
Asch and Ruth M. Parker 238
2. Medical Practice in Social Context 244
Presidential Address: The Boundaries of Medicine / Donald W. Seldin 244
The Boundaries of Medicine / Gerald T. Perkoff 254
The Changing Demography of the Medical Profession / Arnold S. Relman 263
Medicine is No Longer a Man's Profession: Or, When the Men's Club Goes Coed
It's Time to Change the Regs / Carola Eisenberg 266
The Doctors of Hoyland / Sir Arthur Conan Doyle 270
3. Relationships between Doctors and Patients 277
The Basic Models of the Doctor-Patient Relationship / Thomas S. Szasz and
Marc H. Hollender 278
Facing Our Mistakes / David Hilfiker 287
Simple Living and Hard Choices / Maureen A. Flannery 293
The Paid Nurse / William Carlos Williams 300
Part IV. Health Care Ethics and the Provider's Role
Introduction / Nancy M. P. King 304
1. The Provider-Patient Relationship 309
Bioethics in Social Context / Larry R. Churchill 310
The Use of Force / William Carlos Williams 320
Case Study: The "Student Doctor" and a Wary Patient / Marc D. Basson,
Gerald Dworkin, and Eric J. Cassell 323
Truth Telling to the Patient / Antonella Surbone 326
Is Truth Telling to the Patient a Cultural Artifact? / Edmund D. Pellegrino
330
Offering Truth: One Ethical Approach to the Uninformed Cancer Patient /
Benjamin Freedman 333
What the Doctor Said / Raymond Carver 341
Informed Consent, Cancer, and Truth in Prognosis / George J. Annas 341
Swapping Stories: A Matter of Ethics / Judith Andre 346
Case Study: Please Don't Tell / Leonard Fleck and Marcia Angell 349
2. Interests in Conflict 353
Cesareans and Samaritans / Nancy K. Rhoden 354
Justified Limits on Refusing Intervention / Frank A. Chervenak and Laurence
B. McCullough 365
Faith (Healing), Hope, and Charity at the FDA: The Politics of AIDS Drug
Trials / George J. Annas 375
Case Study: The Doctor's Unproven Beliefs and the Subjects Informed Choice
/ Don Marquis 386
3. Choices about Treatment 391
Disconnecting a Ventilator at the Request of a Patient Who Knows He Will
Then Die: The Doctor's Anguish / Miles J. Edwards and Susan W. Tolle 393
The Last Words of My English Grandmother / William Carlos Williams 398
Death and Dignity: A Case of Individualized Decision Making / Timothy E.
Quill 399
Informed Demand for "Non-Beneficial" Medical Treatment / Steven H. Miles
403
The Case of Helga Wanglie: A New Kind of "Right to Die" Case / Marcia
Angell 407
Part V. Medical Care Financing, Rationing, and Managed Care
Introduction / Larry R. Churchill 410
1. Medical Care Financing 415
Paying for Medical Care in America / Donald L. Madison 415
Reforming the Health Care System: The Universal Dilemma / Uwe E. Reinhardt
446
2. Rationing: The Dilemmas of Fair Distribution 460
The "Rationing" of Medical Care / Victor R. Fuchs 461
The Prostitute, the Playboy, and the Poet: Rationing Schemes for Organ
Transplantation / George J. Annas 464
Ethics of Queuing for Coronary Artery Bypass Grafting in Canada / Jafna L.
Cox 469
Rationing in Practice: The Case of In Vitro Fertilisation / Sharon Redmayne
and Rudolf Klein 475
3. Managed Care and the Physician's Changing Role 481
Hippocrates and the Health Maintenance Organization: A Discussion of
Ethical Issues / Gail Povar and Jonathan Moreno 482
Physicians and Business Managers: A Clash of Cultures / Arnold S. Relman
491
Preserving the Physician-Patient Relationship in the Era of Managed Care /
Ezekiel J. Emanuel and Nancy Neveloff Dubler 495
Bibliography 510
Acknowledgment of Copyrights 514
Index to Authors 517