This volume moves beyond ethics as problem-solving or ethics as etiquette to offer a look at ethics in primary care—as opposed to life-or-death—medical care. Professional Ethics and Primary Care Medicine deals with the ethics of routine, day-to-day encounters between doctors and patients. It probes beneath the hard decisions to look at the moral frameworks, habits of thought, and customs of practice that underlie choices. Harmon Smith and Larry Churchill argue that primary care, far from being merely a setting for the rendering of care, provides a new understanding of both physician and patient, and thereby offers a fresh basis for medical ethics.

Slow Cures and Bad Philosophers uses insights from the philosophy of Ludwig Wittgenstein to rethink bioethics. Although Wittgenstein produced little formal writing on ethics, this volume shows that, in fact, ethical issues permeate the entirety of his work. The scholars whom Carl Elliott has assembled in this volume pay particular attention to Wittgenstein’s concern with the thick context of moral problems, his suspicion of theory, and his belief in description as the real aim of philosophy. Their aim is not to examine Wittgenstein’s personal moral convictions but rather to explore how a deep engagement with his work can illuminate some of the problems that medicine and biological science present.
As Elliott explains in his introduction, Wittgenstein’s philosophy runs against the grain of most contemporary bioethics scholarship, which all too often ignores the context in which moral problems are situated and pays little attention to narrative, ethnography, and clinical case studies in rendering bioethical judgments. Such anonymous, impersonal, rule-writing directives in which health care workers are advised how to behave is what this volume intends to counteract. Instead, contributors stress the value of focusing on the concrete particulars of moral problems and write in the spirit of Wittgenstein’s belief that philosophy should be useful. Specific topics include the concept of “good dying,” the nature of clinical decision making, the treatment of neurologically damaged patients, the moral treatment of animals, and the challenges of moral particularism.
Inspired by a philosopher who deplored “professional philosophy,” this work brings some startling insights and clarifications to contemporary ethical problems posed by the realities of modern medicine.

Contributors. Larry Churchill, David DeGrazia, Cora Diamond, James Edwards, Carl Elliott, Grant Gillett, Paul Johnston, Margaret Olivia Little, James Lindemann Nelson, Knut Erik Tranoy

To meet the needs of the rapidly changing world of health care, future physicans and health care providers will need to be trained to become wiser scientists and humanists in order to understand the social and moral as well as technological aspects of health and illness. The Social Medicine Reader is designed to meet this need.
Based on more than a decade of teaching social medicine to first-year medical students at the pioneering Department of Social Medicine at the University of North Carolina, The Social Medicine Reader defines the meaning of the social medicine perspective and offers an approach for teaching it. Looking at medicine from a variety of perspectives, this anthology features fiction, medical reports, scholarly essays, poetry, case studies, and personal narratives by patients and doctors—all of which contribute to an understanding of how medicine and medical practice is profoundly influenced by social, cultural, political, and economic forces.
What happens when a person becomes a patient? How are illness and disability experienced? What causes disease? What can medicine do? What constitutes a doctor/patient relationship? What are the ethical obligations of a health care provider? These questions and many others are raised by The Social Medicine Reader, which is organized into sections that address how patients experience illness, cultural attitudes toward disease, social factors related to health problems, the socialization of physicians, the doctor/patient relationship, health care ethics and the provider’s role, medical care financing, rationing, and managed care.

Duke University Press is pleased to announce the second edition of the bestselling Social Medicine Reader. The Reader provides a survey of the challenging issues facing today’s health care providers, patients, and caregivers by bringing together moving narratives of illness, commentaries by physicians, debates about complex medical cases, and conceptually and empirically based writings by scholars in medicine, the social sciences, and the humanities. The first edition of The Social Medicine Reader was a single volume. This significantly revised and expanded second edition is divided into three volumes to facilitate use by different audiences with varying interests.

Praise for the 3-volume second edition of The Social Medicine Reader:
“A superb collection of essays that illuminate the role of medicine in modern society. Students and general readers are not likely to find anything better.”—Arnold S. Relman, Professor Emeritus of Medicine and Social Medicine, Harvard Medical School

Praise for the first edition:
“This reviewer strongly recommends The Social Medicine Reader to the attention of medical educators.”—Samuel W. Bloom, JAMA: The Journal of the American Medical Association

Volume 3:

Over the past four decades the American health care system has witnessed dramatic changes in private health insurance, campaigns to enact national health insurance, and the rise (and perhaps fall) of managed care. Bringing together seventeen pieces new to this second edition of The Social Medicine Reader and four pieces from the first edition, Health Policy, Markets, and Medicine draws on a broad range of disciplinary perspectives—including political science, economics, history, and bioethics—to consider changes in health care and the future of U.S. health policy. Contributors analyze the historical and moral foundation of today’s policy debates, examine why health care spending is so hard to control in the United States, and explain the political dynamics of Medicare and Medicaid. Selections address the rise of managed care, its impact on patients and physicians, and the ethical implications of applying a business ethos to medical care; they also compare the U.S. health care system to the systems in European countries, Canada, and Japan. Additional readings probe contemporary policy issues, including the emergence of consumer-driven health care, efforts to move quality of care to the top of the policy agenda, and the implications of the aging of America for public policy.

Contributors: Henry J. Aaron, Drew E. Altman, George J. Annas, Robert H. Binstock, Thomas Bodenheimer, Troyen A. Brennan, Robert H. Brook, Lawrence D. Brown, Daniel Callahan, Jafna L. Cox, Victor R. Fuchs, Kevin Grumbach, Rudolf Klein, Robert Kuttner, Larry Levitt, Donald L. Madison, Wendy K. Mariner, Elizabeth A. McGlynn, Jonathan Oberlander, Geov Parrish, Sharon Redmayne, Uwe E. Reinhardt, Michael S. Sparer, Deborah Stone

Duke University Press is pleased to announce the second edition of the bestselling Social Medicine Reader. The Reader provides a survey of the challenging issues facing today’s health care providers, patients, and caregivers by bringing together moving narratives of illness, commentaries by physicians, debates about complex medical cases, and conceptually and empirically based writings by scholars in medicine, the social sciences, and the humanities. The first edition of The Social Medicine Reader was a single volume. This significantly revised and expanded second edition is divided into three volumes to facilitate use by different audiences with varying interests.

Praise for the 3-volume second edition of The Social Medicine Reader:
“A superb collection of essays that illuminate the role of medicine in modern society. Students and general readers are not likely to find anything better.”—Arnold S. Relman, Professor Emeritus of Medicine and Social Medicine, Harvard Medical School

Praise for the first edition:
“This reviewer strongly recommends The Social Medicine Reader to the attention of medical educators.”—Samuel W. Bloom, JAMA: The Journal of the American Medical Association

Volume 1:

A woman with what is quite probably a terminal illness must choose between courses of treatment based on contradictory diagnoses. A medical student causes acute pain in his patients as he learns to insert a central line. One doctor wonders how to react when a patient asks him to pray with her; another struggles to come to terms with his mistakes. A physician writes in a prominent medical journal about facilitating a dying woman’s wish to end her life on her own terms; letters to the editor reflect passionate responses both in support of and in opposition to his actions. These experiences and many more are vividly rendered in Patients, Doctors, and Illness, which brings together nineteen pieces that appeared in the first edition of The Social Medicine Reader and eighteen pieces new to this edition. This volume examines the roles and training of health care professionals and their relationship with patients, ethics in health care, and end-of-life experiences and decisions. It includes fiction and nonfiction narratives and poetry; definitions and case-based discussions of moral precepts in health care, such as truth telling, informed consent, privacy, and autonomy; and readings that provide legal, ethical, and practical perspectives on many familiar but persistent ethical and social questions raised by illness and care.

Contributors: Yehuda Amichai, Marcia Angell, George J. Annas, Marc D. Basson, Doris Betts, Amy Bloom, Abenaa Brewster, Raymond Carver, Eric J. Cassell, Larry R. Churchill, James Dickey, Gerald Dworkin, James Dwyer, Miles J. Edwards, Charles R. Feldstein, Chris Feudtner, Leonard Fleck, Arthur Frank, Benjamin Freedman, Atul Gawande, Jerome Groopman, Lawrence D. Grouse, David Hilfiker, Nancy M. P. King, Perri Klass, Melvin Konner, Bobbie Ann Mason, Steven H. Miles, Sharon Olds, Katha Pollitt, Timothy E. Quill, David Schenck, Daniel Shapiro, Susan W. Tolle, Alice Stewart Trillin, William Carlos Williams

Duke University Press is pleased to announce the second edition of the bestselling Social Medicine Reader. The Reader provides a survey of the challenging issues facing today’s health care providers, patients, and caregivers by bringing together moving narratives of illness, commentaries by physicians, debates about complex medical cases, and conceptually and empirically based writings by scholars in medicine, the social sciences, and the humanities. The first edition of The Social Medicine Reader was a single volume. This significantly revised and expanded second edition is divided into three volumes to facilitate use by different audiences with varying interests.

Praise for the 3-volume second edition of The Social Medicine Reader:
“A superb collection of essays that illuminate the role of medicine in modern society. Students and general readers are not likely to find anything better.”—Arnold S. Relman, Professor Emeritus of Medicine and Social Medicine, Harvard Medical School

Praise for the first edition:
“This reviewer strongly recommends The Social Medicine Reader to the attention of medical educators.”—Samuel W. Bloom, JAMA: The Journal of the American Medical Association

Volume 2:

Ranging from a historical look at eugenics to an ethnographic description of parents receiving the news that their child has Down syndrome, from analyses of inequalities in the delivery of health services to an examination of the meaning of race in genomics research, and from a meditation on the loneliness of the long-term caregiver to a reflection on what children owe their elderly parents, this volume explores health and illness. Social and Cultural Contributions to Health, Difference, and Inequality brings together seventeen pieces new to this edition of The Social Medicine Reader and five pieces that appeared in the first edition. It focuses on how difference and disability are defined and experienced in contemporary America, how the social categories commonly used to predict disease outcomes—such as gender, race and ethnicity, and social class—have become contested terrain, and why some groups have more limited access to health care services than others. Juxtaposing first-person narratives with empirical and conceptual studies, this compelling collection draws on several disciplines, including cultural and medical anthropology, sociology, and the history of medicine.

Contributors: Laurie K. Abraham, Raj Bhopal, Ami S. Brodoff, Daniel Callahan, David Diamond, Liam Donaldson, Alice Dreger, Sue E. Estroff, Paul Farmer, Anne Fausto-Sterling, Jerome Groopman, Gail E. Henderson, Linda M. Hunt, Barbara A. Koenig, Donald R. Lannin, Sandra Soo-Jin Lee, Carol Levine, Judith Lorber, Nancy Mairs, Holly F. Mathews, James P. Mitchell, Joanna Mountain, Alan R. Nelson, Martin S. Pernick, Rayna Rapp, Sally L. Satel, Robert S. Schwartz, Brian D. Smedley, Adrienne Y. Stith, Sharon Sytsma, Gordon Weaver, Bruce Wilson, Irving Kenneth Zola

The extensively updated and revised third edition of the bestselling Social Medicine Reader provides a survey of the challenging issues facing today's health care providers, patients, and caregivers by bringing together moving narratives of illness, commentaries by physicians, debates about complex medical cases, and conceptually and empirically based writings by scholars in medicine, the social sciences, and the humanities.

Volume 1, Ethics and Cultures of Biomedicine, contains essays, case studies, narratives, fiction, and poems that focus on the experiences of illness and of clinician-patient relationships. Among other topics the contributors examine the roles and training of professionals alongside the broader cultures of biomedicine; health care; experiences and decisions regarding death, dying, and struggling to live; and particular manifestations of injustice in the broader health system. The Reader is essential reading for all medical students, physicians, and health care providers.

The extensively updated and revised third edition of the bestselling Social Medicine Reader provides a survey of the challenging issues facing today's health care providers, patients, and caregivers with writings by scholars in medicine, the social sciences, and the humanities.