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In this companion volume to their 1981 work, A Philosophical Basis of Medical Practice, Pellegrino and Thomasma examine the principle of beneficence and its role in the practice of medicine. Their analysis, which is grounded in a thorough-going philosophy of medicine, addresses a wide array of practical and ethical concerns that are a part of health care decision-making today. Among these issues are the withdrawing and withholding of nutrition and hydration, competency assessment, the requirements for valid surrogate decision-making, quality-of-life determinations, the allocation of scarce health care resources, medical gatekeeping, and for-profit medicine. The authors argue for the restoration of beneficence (re-interpreted as beneficence-in-trust) to its place as the fundamental principle of medical ethics. They maintain that to be guided by beneficence a physician must perform a right and good healing action which is consonant with the individual patient's values. In order to act in the patient's best interests, or the patient's good, the physician and patient must discern what that good is. This knowledge is gained only through a process of dialogue between patient and/or family and physician which respects and honors the patient's autonomous self-understanding and choice in the matter of treatment options. This emphasis on a dialogical discernment of the patient's good rejects the assumption long held in medicine that what is considered to be the medical good is necessarily the good for this patient. In viewing autonomy as a necessary condition of beneficence, the authors move beyond a trend in the medical ethics literature which identifies beneficence with paternalism. In their analysis of beneficence, the authors reject the current emphasis on rights- and duty-based ethical systems in favor of a virtue-based theory which is grounded in the physician-patient relationship. This book's provocative contributions to medical ethics will be of great interest not only to physicians and other health professionals, but also to ethicists, students, patients, families, and all others concerned with the relationship of professional to patient and patient to professional in health care today.
The second edition of Putting Patients First showcases what Planetree facilities and the Planetree organization have learned about the commitments, conditions, practices, and policies that are needed to do more than give lip service to being--patient-centered.--It should be read by every student, nurse, physician, administrator, trustee, policy maker, and lay person who is committed to creating healing environments, holding facilities accountable for their rhetoric, and truly reforming health care.
This oft-quoted all-time favorite of the medical community will gladden--and strengthen--the hearts of patients, doctors, and anyone entering medical study, internship, or practice. With unassailable logic and rapier wit, the sage Dr. Oscar London muses on the challenges and joys of doctoring, and imparts timeless truths, reality checks, and poignant insights gleaned from 30 years of general practice--while never taking himself (or his profession) too seriously. The classic book on the art and humor of practicing medicine, celebrating its 20th anniversary in a new gift edition with updates throughout. Previous editions have sold more than 200,000 copies. The perfect gift for med students and grads as well as new and practicing physicians. Approximately 17,000 students graduate from med school each spring in North America.
For many doctors, their role as powerful healer precludes thoughts of ever getting sick themselves. When they do, it initiates a profound shift of awareness-- not only in their sense of their selves, which is invariably bound up with the "invincible doctor" role, but in the way that they view their patients and the doctor-patient relationship. While some books have been written from first-person perspectives on doctors who get sick-- by Oliver Sacks among them-- and TV shows like "House" touch on the topic, never has there been a "systematic, integrated look" at what the experience is like for doctors who get sick, and what it can teach us about our current health care system and more broadly, the experience of becoming ill.The psychiatrist Robert Klitzman here weaves together gripping first-person accounts of the experience of doctors who fall ill and see the other side of the coin, as a patient. The accounts reveal how dramatic this transformation can be-- a spiritual journey for some, a radical change of identity for others, and for some a new way of looking at the risks and benefits of treatment options. For most however it forever changes the way they treat their own patients. These questions are important not just on a human interest level, but for what they teach us about medicine in America today. While medical technology advances, the health care system itself has become more complex and frustrating, and physician-patient trust is at an all-time low. The experiences offered here are unique resource that point the way to a more humane future.
"[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.
This book introduces the reader to the basic skills necessary for good communication between doctors (and other health professionals) and patients. The practical importance of such skills is outlined, making the doctor much more effective in all fields of medicine. This is not a book for the specialist reader, but aimed at all those who need to talk with patients.
An analysis of how findings in behavioral economics challenge fundamental assumptions of medical ethics, integrating the latest research in both fields. Bioethicists have long argued for rational persuasion to help patients with medical decisions. But the findings of behavioral economics—popularized in Thaler and Sunstein’s Nudge and other books—show that arguments depending on rational thinking are unlikely to be successful and even that the idea of purely rational persuasion may be a fiction. In Good Ethics and Bad Choices, Jennifer Blumenthal-Barby examines how behavioral economics challenges some of the most fundamental tenets of medical ethics. She not only integrates the latest research from both fields but also provides examples of how physicians apply concepts of behavioral economics in practice. Blumenthal-Barby analyzes ethical issues raised by “nudging” patient decision making and argues that the practice can improve patient decisions, prevent harm, and perhaps enhance autonomy. She then offers a more detailed ethical analysis of further questions that arise, including whether nudging amounts to manipulation, to what extent and at what point these techniques should be used, when and how their use would be wrong, and whether transparency about their use is required. She provides a snapshot of nudging “in the weeds,” reporting on practices she observed in clinical settings including psychiatry, pediatric critical care, and oncology. Warning that there is no “single, simple account of the ethics of nudging,” Blumenthal-Barby offers a qualified defense, arguing that a nudge can be justified in part by the extent to which it makes patients better off.
An experienced and compassionate physician questions the prevailing medical model of patient care?that every illness has a physical cause that can be identified and treated medically?and argues for the necessity of taking the psychological and social situation of the patient into account in the process of diagnosis and treatment.
“People come to us for help. They come for health and strength.” With these simple words David Mendel begins Proper Doctoring, a book about what it means (and takes) to be a good doctor, and for that reason very much a book for patients as well as doctors—which is to say a book for everyone. In crisp, clear prose, he introduces readers to the craft of medicine and shows how to practice it. Discussing matters ranging from the most basic—how doctors should dress and how they should speak to patients—to the taking of medical histories, the etiquette of examinations, and the difficulties of diagnosis, Mendel moves on to consider how the doctor can best serve patients who suffer from prolonged illness or face death. Throughout he keeps in sight the fundamental moral fact that the relationship between doctor and patient is a human one before it is a professional one. As he writes with characteristic concision, “The trained and experienced doctor puts himself, or his nearest and dearest, in the patient’s position, and asks himself what he would do if he were advising himself or his family. No other advice is acceptable; no other is justifiable.” Proper Doctoring is a book that is admirably direct, as well as wise, witty, deeply humane, and, frankly, indispensable.
This book is open access under a CC BY 4.0 license. This book examines the concept of care and care practices in healthcare from the interdisciplinary perspectives of continental philosophy, care ethics, the social sciences, and anthropology. Areas addressed include dementia care, midwifery, diabetes care, psychiatry, and reproductive medicine. Special attention is paid to ambivalences and tensions within both the concept of care and care practices. Contributions in the first section of the book explore phenomenological and hermeneutic approaches to care and reveal historical precursors to care ethics. Empirical case studies and reflections on care in institutionalised and standardised settings form the second section of the book. The concluding chapter, jointly written by many of the contributors, points at recurring challenges of understanding and practicing care that open up the field for further research and discussion. This collection will be of great value to scholars and practitioners of medicine, ethics, philosophy, social science and history.