AIDS and the National Body
Thomas E. Yingling Duke University Press, 1997 Library of Congress RA644.A25Y56 1997 | Dewey Decimal 362.196979200973
Thomas Yingling was a rising star in American studies, a leading figure in gay and lesbian studies, and a prominent theorist of AIDS and cultural politics when he died in 1992. AIDS and the National Body is a brilliant excursion into the mind and heart of Yingling, author of the critically acclaimed book, Hart Crane and the Homosexual Text. Robyn Wiegman, a friend and colleague of Yingling’s, has collected in this book a selection of his critical and creative work. These previously published and unpublished essays, nonacademic prose, poetry, and letters are a powerful testimonial to the intellectual legacy left by Yingling. Contemplating the contradictions of individual identity from within a human body adapting to and living within a collective national culture, Yingling delves into such issues as canon formation, poetic theory, and the rhetoric of the body in American popular culture. In addition to Wiegman’s illuminating introduction, the conversation is joined by four other scholars—Michael Awkward, Robert L. Caserio, Stephen Melville, and David Román—whose critical and personal responses to Yingling’s writing weigh in throughout the volume. What emerges is a collection that embodies the particular difficulties of living with AIDS, of outliving someone who has died of AIDS, and of losing prematurely an important thinker.
Camcorder AIDS activism is a prime example of a new form of political expression—an outburst of committed, low-budget, community-produced, political video work made possible by new accessible technologies. As Alexandra Juhasz looks at this phenomenon—why and how video has become the medium for so much AIDS activism—she also tries to make sense of the bigger picture: How is this work different from mainstream television? How does it alter what we think of the media’s form and function? The result is an eloquent and vital assessment of the role media activism plays in the development of community identity and self-empowerment.
An AIDS videomaker herself, Juhasz writes from the standpoint of an AIDS activist and blends feminist film critique with her own experience. She offers a detailed description of alternative AIDS video, including her own work on the Women’s AIDS Video Enterprise (WAVE). Along with WAVE, Juhasz discusses amateur video tapes of ACT UP demonstrations, safer sex videos produced by Gay Men’s Health Crisis, public access programming, and PBS documentaries, as well as network television productions.
From its close-up look at camcorder AIDS activism to its critical account of mainstream representations, AIDS TV offers a better understanding of the media, politics, identity, and community in the face of AIDS. It will challenge and encourage those who hope to change the course of this crisis both in the ‘real world’ and in the world of representation.
Alive with Alzheimer's
Cathy Stein Greenblat University of Chicago Press, 2004 Library of Congress RC523.G745 2004 | Dewey Decimal 362.19683100222
The confusion, losses, and devastation of Alzheimer's disease are familiar to the millions of Americans suffering from the disease and to their family members. Understandably, declining abilities and changing personal characteristics shape our picture of the disease, leading some to refer to the "double death" of Alzheimer's in which the sufferer drifts away long before his or her eventual physical end.
This small, tender volume of 85 photographs and accompanying discussion powerfully shows the limitations of this view. Cathy Stein Greenblat, an internationally respected sociologist and photographer, demonstrates in Alive with Alzheimer's that, while the ravages of the disease are real, Alzheimer's sufferers can do more than survive, they can thrive. Her images, interviews, and observations attest to the possibility of their being "alive" with Alzheimer's far beyond the expectations of the general public and even of many physicians with long experience with the disease.
Greenblat offers a new vision, taking us into a world of life-enhancing institutional care. Nursing homes and similar facilities don't have to be a last resort; as Greenblat shows, with a dedicated and experienced staff and an enriched environment (that includes respect, choices, pets, and music), extraordinary changes can be effected in Alzheimer's patients. Alive with Alzheimer's, the first photographic book on the disease, offers hope and inspiration. Moreover, its vivid, impressive evidence that ongoing stimulation in a good institutional setting can sustain Alzheimer's patients at a far higher level than is generally believed has significant implications for personal and policy decisions.
The new standard of care chronicled in Alive with Alzheimer's will provide hope and inspiration to those touched by the disease. As Dr. Enid Rockwell writes in her Afterword to Greenblat's moving book, "These photographs are extraordinary for practitioners, for family members, for everyone to see what's going on with these people. The stimulation pictured in this book is more powerful than any medication that we will have in our lifetime. . . . They so vividly show us that there are people inside these bodies, people with personalities, who experience emotion, and they show that there is life after Alzheimer's."
“Wall traces the nursing and management roles of nuns and brothers in church-related US health care institutions. This well-documented volume will be a useful addition for collections supporting academic programs in public health, hospital administration, bioethics, and divinity, and for comprehensive collections in the history of medicine. Recommended.” —Choice
“American Catholic Hospitals is fair, balanced, insightful, and intriguing. The story Wall tells—a story about a significant segment of the US health care system—is meticulously documented. Readers will find her study to be illuminating, even inspirational.” —Journal of the American Medical Association
“In American Catholic Hospitals, Barbra Mann Hall traces the ways Catholic hospitals have accommodated changes both within the church and in society over the last century. Her book is well researched and a fascinating read.” —Health Progress
“Wall presents a compelling and well-documented narrative of the dynamic transformation of Catholic hospitals in twentieth-century America. Drawing on records from Catholic congregations throughout the United States, she reveals an admirable perseverance of religious caregivers, demonstrated by their willingness to adapt to socioeconomic forces often inimical to charitable care.” —American Catholic Studies
“American Catholic Hospitals is meticulously researched and well written. Although it is certainly appropriate for both undergraduate and graduate students, general readers also will find it to be an excellent overview of the history of the changes that Catholic health-care institutions have undergone in the twentieth and twenty-first centuries.” —Catholic Historical Review
“American Catholic Hospitals offers a tremendous amount of new material and refreshing perspectives on current health care system challenges in the United States.” —Sioban Nelson, Bloomberg Faculty of Nursing, University of Toronto
“Wall provides solid scholarship and engaging insight into the historic and contemporary contributions of American Catholic hospitals and their ability to adapt and serve amid the changing landscapes of church and state, culture wars, and healthcare reforms of the 20th century.” —Carol K. Coburn, author of Spirited Lives: How Nuns Shaped Catholic Culture and American Life, 1836-1920
A revolution in American medicine is in full swing, with the race from fee-for-service to fee-for-value at the front line in an epic battle that will transform healthcare delivery for decades to come. In America’s Healthcare Transformation, eminent physician leader Robert A. Phillips brings together key thought leaders and trail-blazing practitioners, who provide a wide-ranging exploration of the strategies, innovations, and paradigm shifts that are driving this healthcare transformation.
The contributors offer a panoramic look at the dramatic changes happening in the field of medicine, changes that put the patient at the heart of the process. Among other subjects, the essays evaluate innovative high quality and low cost care delivery solutions from around the United States and abroad, describe fundamental approaches to measuring the safety of care and the impact that guidelines have on improving quality of care and outcomes, and make a strong case that insurance reform will fundamentally and irreversibly drive delivery reform. In addition, America’s Healthcare Transformation reviews the role of health information technology in creating safer healthcare, provides a primer on the development of a culture of safety, and highlights ground-breaking new ways to train providers in patient safety and quality. Finally, the book looks at reports from Stanford Health Care and Houston Methodist which outline how successful behaviorally based strategies, anchored in values, can energize and empower employees to deliver a superior patient experience.
Drawing on the wisdom and vision of today’s leading healthcare innovators, America’s Healthcare Transformation provides a roadmap to the future of American healthcare. This book is essential reading for all health care providers, health care administrators, and health policy professionals, and it will be an invaluable resource in the effort to improve the practice of medicine and the delivery of healthcare in our communities and nation.
Vividly documenting the real world of the contemporary hospital, its nurses, and their moral and ethical crises, Dan Chambliss offers a sobering revelation of the forces shaping moral decisions in our hospitals.
Based on more than ten years' field research, Beyond Caring is filled with eyewitness accounts and personal stories demonstrating how nurses turn the awesome into the routine. It shows how patients, many weak and helpless, too often become objects of the bureaucratic machinery of the health care system and how ethics decisions, once the dilemmas of troubled individuals, become the setting for political turf battles between occupational interest groups. The result is a compelling combination of realism and a powerful theoretical argument about moral life in large organizations.
The Body Multiple is an extraordinary ethnography of an ordinary disease. Drawing on fieldwork in a Dutch university hospital, Annemarie Mol looks at the day-to-day diagnosis and treatment of atherosclerosis. A patient information leaflet might describe atherosclerosis as the gradual obstruction of the arteries, but in hospital practice this one medical condition appears to be many other things. From one moment, place, apparatus, specialty, or treatment, to the next, a slightly different “atherosclerosis” is being discussed, measured, observed, or stripped away. This multiplicity does not imply fragmentation; instead, the disease is made to cohere through a range of tactics including transporting forms and files, making images, holding case conferences, and conducting doctor-patient conversations.
The Body Multiple juxtaposes two distinct texts. Alongside Mol’s analysis of her ethnographic material—interviews with doctors and patients and observations of medical examinations, consultations, and operations—runs a parallel text in which she reflects on the relevant literature. Mol draws on medical anthropology, sociology, feminist theory, philosophy, and science and technology studies to reframe such issues as the disease-illness distinction, subject-object relations, boundaries, difference, situatedness, and ontology. In dialogue with one another, Mol’s two texts meditate on the multiplicity of reality-in-practice.
Presenting philosophical reflections on the body and medical practice through vivid storytelling, The Body Multiple will be important to those in medical anthropology, philosophy, and the social study of science, technology, and medicine.
In recent years, the hospital industry has been undergoing massive change and reorganization with technological innovations and the spread of managed care. As a result, the total number of hospitals countrywide has been declining, and a growing number of not-for-profit hospitals have converted to for-profit status. These changes raise two fundamental questions: What determines a hospital's choice of for-profit or not-for-profit organizational form? And how does that form affect patients and society?
This timely volume provides a factual basis for discussing for-profit versus not-for-profit ownership of hospitals and gives a first look at the evidence about new and important issues in the hospital industry. The Changing Hospital Industry: Comparing Not-for-Profit and For-Profit Institutions will have significant implications for public-policy reforms in this vital industry and will be of great interest to scholars in the fields of health economics, public finance, hospital organization, and management; and to health services researchers.
Little is known about the experiences of children living in families affected by severe and enduring mental illness. This is the first in-depth study of children and young people caring for parents affected in this way. Drawing on primary research data collected from 40 families, the book presents the perspectives of children (young carers), their parents and the key professionals in contact with them. Children caring for parents with mental illness makes an invaluable contribution to the growing evidence base on parental mental illness and outcomes for children. It:·[vbTab]is the first research-based text to examine the experiences and needs of children caring for parents with severe mental illness;·[vbTab]provides the perspectives of children, parents and key professionals in contact with these families;·[vbTab]reviews existing medical, social, child protection and young carers literatures on parental mental illness and consequences for children; ·[vbTab]provides a chronology and guide to relevant law and policy affecting young carers and parents with severe mental illness;·[vbTab]makes concrete recommendations and suggestions for improving policy and professional practice;·[vbTab]contributes to the growing evidence base on parental mental illness and outcomes for children and families.
Children’s Mental Health
Leonard Saxe Duke University Press, 1987 Library of Congress RJ501.A2S28 1987 | Dewey Decimal 362.198928900973
The important mental health problems of children have become the focus of increasing public awareness in the past few years. Adolescent suicide, the physical, emotional, and sexual abuse of children, alcohol and drug abuse by young people, as well as psychiatric hospitalization of children and adolescents have fueled a growing debate on mental illness and mental health services for our young children.
This book was prepared by the Office of Technology Assessment at the request of Senators Mark Hatfield and Daniel Inouye. It acknowledges that there are no simple solutions to the problems we face or easy answers to questions concerning the best system of mental health service delivery. Yet Children's Mental Health makes it abundantly clear that there is a need for a mental health system response to these issues and that this response must be coordinated with other existing service systems.
This book should be of value to concerned parents and community leaders, health system planners, and health care practitioners involved with both the needs of children and mental illness.
As a traditional healing art that has established a contemporary global presence, Chinese medicine defies categories and raises many interesting questions. If Chinese medicine is "traditional," why has it not disappeared with the rest of traditional Chinese society? If, as some claim, it is a science, what does that imply about what we call science? What is the secret of Chinese medicine's remarkable adaptability that has allowed it to prosper for more than 2,000 years? In Chinese Medicine in Contemporary China Volker Scheid presents an ethnography of Chinese medicine that seeks to answer these questions, but his ethnography is informed by some atypical approaches. Scheid, a medical anthropologist and practitioner of Chinese medicine in practice since 1983, has produced an ethnography that accepts plurality as an intrinsic and nonreducible aspect of medical practice. It has been widely noted that a patient visiting ten different practitioners of Chinese medicine may receive ten different prescriptions for the same complaint, yet many of these various treatments may be effective. In attempting to illuminate the plurality in Chinese medical practice, Scheid redefines-and in some cases abandons-traditional anthropological concepts such as tradition, culture, and practice in favor of approaches from disciplines such as science and technology studies, social psychology, and Chinese philosophy. As a result, his book sheds light not only on Chinese medicine but also on the Western academic traditions used to examine it and presents us with new perspectives from which to deliberate the future of Chinese medicine in a global context. Chinese Medicine in Contemporary China is the product of two decades of research including numerous interviews and case studies. It will appeal to a western academic audience as well as practitioners of Chinese medicine and other interested medical professionals, including those from western biomedicine.
Chronic Failures: Kidneys, Regimes of Care and the Mexican State is about Chronic Kidney Disease (CKD) and the relentless search for renal care lived out in the context of poverty, inequality and uneven welfare arrangements. Based on ethnographic research conducted in the state of Jalisco, this book documents the routes uninsured Mexican patients take in order to access resource intensive biotechnical treatments, that is, different modes of dialysis and organ transplantation. It argues that these routes are normalized, bureaucratically, socially and epidemiologically, and turned into a locus for exploitation and profit. Without a coherent logic of healthcare access, negotiating regimes of renal care has catastrophic consequences for those with the least resources to expend in that effort. In carrying both the costs and the burden of care, the practices of patients without entitlement offer a critical vantage point on the interplay between the state, markets in healthcare and the sick body.
Since the early twentieth century, politically engaged and socially committed U.S. health professionals have worked in solidarity with progressive movements around the world. Often with roots in social medicine, political activism, and international socialism, these doctors, nurses, and other health workers became comrades who joined forces with people struggling for social justice, equity, and the right to health.
Anne-Emanuelle Birn and Theodore M. Brown bring together a group of professionals and activists whose lives have been dedicated to health internationalism. By presenting a combination of historical accounts and first-hand reflections, this collection of essays aims to draw attention to the longstanding international activities of the American health left and the lessons they brought home. The involvement of these progressive U.S. health professionals is presented against the background of foreign and domestic policy, social movements, and global politics.
World-leading health economist Cam Donaldson defends NHS-type systems on the same basis as their detractors: economic efficiency. However, protecting government funding of health care is not enough: scarcity has to be managed. Donaldson goes on to show how we can get more out of our systems by addressing issues of value for money. In particular, he demonstrates what has been achieved through health care reform but questions how much more this can deliver relative to getting serious about priority setting.The issues addressed in the book have global relevance and this accessible book will therefore appeal to the public, health professionals and health policy specialists.
The Cultivation of Whiteness is an award-winning history of scientific ideas about race and place in Australia from the time of the first European settlement through World War II. Chronicling the extensive use of biological theories and practices in the construction and “protection” of whiteness, Warwick Anderson describes how a displaced “Britishness” (or whiteness) was defined by scientists and doctors in relation to a harsh, strange environment and in opposition to other races. He also provides the first account of extensive scientific experimentation in the 1920s and 1930s on poor whites in tropical Australia and on Aboriginal people in the central deserts.
“[Anderson] writes with passion, wit, and panache, and the principal virtues of The Cultivation of Whiteness are the old-fashioned ones of thoroughness, accuracy, and impeccable documentation. . . . [His] sensitive study is a model of how contentious historical issues can be confronted.”—W. F. Bynum, Times Literary Supplement
“One of the virtues of The Cultivation of Whiteness is that it brings together aspects of Australian life and history that are now more often separated—race and environment, blood and soil, medicine and geography, tropical science and urban health, biological thought and national policy, Aboriginality and immigration, the body and the mind. The result is a rich and subtle history of ideas that is both intellectual and organic, and that vividly evokes past states of mind and their lingering, haunting power.”—Tom Griffiths, Sydney Morning Herald
In health care delivery and health care research, basic concepts of cultural behavior are ignored—at a high personal and financial cost—because both fields are dominated by technical solutions and quantitative analysis. They have little use for what is often regarded as irrelevant information.
In this wide-ranging book, written for students and non-specialists, Gesler applies cultural geography to health care and shows that throughout the world, in western and developing countries alike, the social sciences can inform the medical sciences nd make them more effective and less expensive.
Dangerous Diagnostics is a powerful study of the pervasiveness of diagnostic testing and the potential it offers institutions to classify, categorize, and ultimately control individuals. Nelkin and Tancredi explore the ethical, social, and legal implications of cutting-edge technologies that can lead to new forms of discrimination in the name of standardized, objective measurements. They caution against the creation of an underclass deemed unemployable, untrainable, or uninsurable by such diagnostic tests.
Demanding Medical Excellence is a groundbreaking and accessible work that reveals how the information revolution is changing the way doctors make decisions. Michael Millenson, a three-time Pulitzer Prize nominee as a health-care reporter for the Chicago Tribune, illustrates serious flaws in contemporary medical practice and shows ways to improve care and save tens of thousands of lives.
"If you read only one book this year, read Demanding Medical Excellence. It's that good, and the revolution it describes is that important."—Health Affairs
"Millenson has done yeoman's work in amassing and understanding that avalanche of data that lies beneath most of the managed-care headlines. . . . What he finds is both important and well-explained: inconsistency, overlap, and inattention to quality measures in medical treatment cost more and are more dangerous than most cost-cutting measures. . . . [This book] elevates the healthcare debate to a new level and deserves a wide readership."—Library Journal
"An involving, human narrative explaining how we got to where we are today and what lies ahead."—Mark Taylor, Philadelphia Inquirer
"Read this book. It will entertain you, challenge, and strengthen you in your quest for better accountability in health care."—Alex R. Rodriguez, M.D., American Journal of Medical Quality
"Finally, a health-care book that doesn't wring its hands over the decline of medicine at the hands of money-grubbing corporations. . . . This is a readable account of what Millenson calls a 'quiet revolution' in health care, and his optimism makes for a refreshing change."—Publishers Weekly
"With meticulous detail, historical accuracy, and an uncommon understanding of the clinical field, Millenson documents our struggle to reach accountability."—Saty Satya-Murti, M.D., Journal of the American Medical Association
If nineteenth-century Britain witnessed the rise of medical professionalism, it also witnessed rampant quackery. It is tempting to categorize historical practices as either orthodox or quack, but what did these terms really signify in medical and public circles at the time? How did they develop and evolve? What do they tell us about actual medical practices?
Doctoring the Novel explores the ways in which language constructs and stabilizes these slippery terms by examining medical quackery and orthodoxy in works such as Mary Shelley’s Frankenstein, Charles Dickens’s Bleak House and Little Dorrit, Charlotte Brontë’s Villette, Wilkie Collins’s Armadale, and Arthur Conan Doyle’s Stark Munro Letters. Contextualized in both medical and popular publishing, literary analysis reveals that even supposedly medico-scientific concepts such as orthodoxy and quackery evolve not in elite laboratories and bourgeois medical societies but in the rough-and-tumble of the public sphere, a view that acknowledges the considerable, and often underrated, influence of language on medical practices.
All advanced health care systems face severe difficulties in financing the delivery of today’s sophisticated medical care. In this study David Wilsford compares the health systems in France and the United States to demonstrate that some political systems are considerably more effective at controlling the cost of care than others. He argues that two variables—the autonomy of the state and the strength and cohesiveness of organized medicine—explain this variance. In France, Wilsford shows, the state is strong in the health policy domain, while organized medicine is weak and divided. Consequently, physicians exercise little influence over health care policymaking. By contrast, in the United States the state is weak, the employers and insurers who pay for health care are fragmented, and organized medicine is strong and well financed. As a result, medical professionals are able to exert a greater influence on policymaking, thus making cost control more difficult. Wilsford extends his comparison to health care systems in the United Kingdom, West Germany, Italy, Canada, and Japan. Whether the private or public sector finances health care, he discovers, there is now an important trend in all of the advanced industrial countries toward controlling escalating costs by curbing both the medical profession’s clinical autonomy and physicians’ incomes.
Economic Aspects of Health
Edited by Victor R. Fuchs University of Chicago Press, 1982 Library of Congress RA410.A2E23 1982 | Dewey Decimal 362.1042
Unlike earlier work in medical economics, which has focused on medical care, these ten papers stress the production and consequences of health itself. They reveal a serious concern with real-world health problems in their investigation of such subjects as infant mortality, life expectancy, morbidity, and disability. These papers are unusual, as well, in bringing to bear on these problems new and powerful theoretical and statistical tools. They draw on, and in some cases are, original sources for new bodies of data. As such, Economic Aspects of Health comprises a useful blend of relevance and rigor.
The landscape of health care is changing rapidly, both on an organizational and a technological level. This book gathers medical anthropologists to examine the ways that both patients and health care workers are being affected by new policies, market, and technologies. Contributors cover a wide range of topics, including vaccination, disability, migration, and self-medication, making clear that not only are changing circumstances leading to the emergence of new socialities, but they are also driving new ethics and moralities.
Eros and Illness
David B. Morris Harvard University Press, 2017 Library of Congress R726.5.M666 2017 | Dewey Decimal 610
When we or our loved ones fall ill, our world is thrown into disarray, our routines are interrupted, our beliefs shaken. David Morris offers an unconventional, deeply human exploration of what it means to live with, and live through, disease. He shows how desire—emotions, dreams, stories, romance, even eroticism—plays a crucial part in illness.
This report describes a comparative analysis of three proposals to allow Americans to keep their existing health plans under the Affordable Care Act (ACA). The proposals are evaluated based on their potential impact on the ACA-compliant market and the cost and coverage of health insurance. The possibility of each proposal causing a “death spiral” in the ACA-compliant market is also addressed.
On its initial publication, Forgive and Remember emerged as the definitive study of the training and lives of young surgeons. Now with an extensive new preface, epilogue, and appendix by the author, reflecting on the changes that have taken place since the book's original publication, this updated second edition of Charles L. Bosk's classic study is as timely as ever.
Cindy Patton University of Minnesota Press, 2002 Library of Congress RA643.8.P38 2002 | Dewey Decimal 362.1969792
A long-awaited look at responses to the AIDS epidemic in relation to globalization.
As AIDS began to appear around the "global village" in the early 1980s, the closeness brought by new technologies no longer promised wondrous cultural exchange; instead it made possible the transmission of a frightening new kind of disease. International scientific institutions and news organizations quickly constructed a "place" for AIDS in the global imaginary: from the heart of Africa and gay bathhouses in San Francisco to the back streets of Southeast Asia and poverty-stricken neighborhoods in the United States. Such simplistic accounts helped recycle racist ideas about Africans and Asians, intensified homophobic visions of irresponsible gay sexuality, and ignored the scientific and human reality of local experiences of the epidemic.
In Globalizing AIDS, pioneering cultural critic Cindy Patton looks at the complex interaction between modern science, media coverage, and local activism during the first decade of the epidemic. Patton's critique of both the production of scientific credibility and the implementation of public health policy at the local level offers a bold reevaluation of how we think about AIDS and an innovative approach to the reality of the disease.
Cindy Patton is a Winship Distinguished Researcher at Emory University. She is the author of Fatal Advice (1996) and Inventing AIDS (1990).
The personal testimony of individuals engaged in healing practices and the opposing voices of orthodox and alternative medicines are the center of Healing Powers. Focusing on medical norms and practices and on competing philosophies of the mind, the body, reality, and rationality across radically different "belief systems", Fred Frohock clarifies the social and legal dilemmas represented by "scientific medicine" and "alternative care."
"Frohock goes beyond the often irreconcilable differences between scientific biomedicine and alternative care by clarifying the social and legal dilemmas they present. . . . A noteworthy contribution forcing us to rethink what medical care is all about."—Jeffrey Michael Clare, Journal of the American Medical Association
"The book does more and better than simply provide a social-scientific proposal. It also gives not only a hearing but a voice to those who follow alternative therapies. . . . Frohock's accounts of their stories—along with the stories of the medical professionals—are eloquent and fascinating."—Allen Verhey, Medical Humanities Review
"Contains a storehouse of valuable information about the historical, philosophical, and psychological bases of alternative approaches to healing."—Marshall B. Kapp, New England Journal of Medicine
"Frohock introduces us to the scientific naturopaths and to physicians who believe in the mind's power to heal, to charismatics who believe in but cannot explain their powers, to those who test God and those who merely accept. He writes so well that I felt I had met these people."—Arthur W. Frank, Christian Century
The individual and structural biases that affect the American healthcare system have serious emotional and physical consequences that all too often go unseen. These biases are often rooted in power, class, racial, gender or sexual orientation prejudices, and as a result, the injured parties usually lack the resources needed to protect themselves. In Healthcare and Human Dignity, individual worth, equality, and autonomy emerge as the dominant values at stake in encounters with doctors, nurses, hospitals, and drug companies. Although the public is aware of legal battles over autonomy and dignity in the context of death, the everyday patient’s need for dignity has received scant attention. Thus, in Healthcare, law professor Frank McClellan’s collection of cases and individual experiences bring these stories to life and establish beyond doubt that human dignity is of utmost priority in the everyday process of healthcare decision making.
When federal and state policy makers’ efforts to enact sweeping health care reform in the mid-1990s ended in stalemate, the private sector unleashed initiatives that have affected virtually every aspect of health care. With updated essays first published in issues of the Journal of Health Politics, Policy and Law, Healthy Markets? offers the most comprehensive and critical examination yet found in a single volume of the economic, political, and social implications of this recent market transformation of health care in the United States. With original contributions from leading social science health policy analysts, this volume addresses the full context of health system change. Believing that the analysis of health care change is too important to be left to economists alone, Mark A. Peterson has collected a mulitdisciplinary group of experts who revisit the contentious debate over the market approaches to health care and consider the disparate effects of these approaches on cost, quality, and coverage of both managed care and Medicaid and Medicare. While market enthusiasts applaud the enhanced efficiency, reduced excess capacity, and abatement of the decades-long health care cost explosion, a backlash has emerged among many providers and the public against the perceived excesses of the market: diminished access to care, commercialization of the physician-patient relationship, and exacerbated inequality. Contributors assess these varied responses while examining the impact that market-based applications are likely to have for future health policy making, the significance of the U.S. experience for policy makers abroad, and the lessons that these changes might provide for thinking sensibly about the future of our health care system. This volume will be useful for public policy analysts, economists, social scientists, health care providers and administrators, and others interested in the future—and in understanding the past—of American health care.
Contributors. Gary S. Belkin, Lawrence D. Brown, Robert G. Evans, Martin Gaynor, Paul B. Ginsburg, Marsha Gold, Theodore R. Marmor, Cathie Jo Martin, Jonathan B. Oberlander, Mark V. Pauly, Mark A. Peterson, Thomas Rice, Deborah A. Stone, William B. Vogt, Kenneth E. Thorpe
Is drug addiction a disease that can be treated, or is it a crime that should be punished? In her probing study, Illness or Deviance?, Jennifer Murphy investigates the various perspectives on addiction, and how society has myriad ways of handling it—incarcerating some drug users while putting others in treatment.
Illness or Deviance? highlights the confusion and contradictions about labeling addiction. Murphy’s fieldwork in a drug court and an outpatient drug treatment facility yields fascinating insights, such as how courts and treatment centers both enforce the “disease” label of addiction, yet their management tactics overlap treatment with “therapeutic punishment.” The “addict" label is a result not just of using drugs, but also of being a part of the drug lifestyle, by selling drugs. In addition, Murphy observes that drug courts and treatment facilities benefit economically from their cooperation, creating a very powerful institutional arrangement.
Murphy contextualizes her findings within theories of medical sociology as well as criminology to identify the policy implications of a medicalized view of addiction.
The HIV/AIDS epidemic has been a major catastrophe for gay communities. In less than two decades, the disease has profoundly changed the lives of gay men and lesbians. Not just a biological and viral agent, HIV has become an opportunistic social invader, reshaping communities and the distribution of wealth, altering the social careers of gay professionals and the patterns of entry into gay and lesbian life, and giving birth to groups like ACT UP and Queer Nation.
The distinguished contributors to this volume discuss the ways HIV/AIDS has changed collective and individual identities, as well as lives, of gay men and lesbians, and how these alterations have changed our perceptions of the epidemic. They cover such topics as the impact of the epidemic on small towns, cultural barriers to AIDS prevention, gay youth and intergenerational relations, and the roles of lesbians in AIDS organizations. This collection provides compelling insights into the new communities among gay men and lesbians and the new kinds of identities and relationships that are emerging from the social and cultural ferment engendered by HIV/AIDS.
Contributors include Barry D. Adam, Lourdes Arguelles, Rafael Miguel Diaz, John H. Gagnon, Gilbert Herdt, Gregory M. Herek, Nan D. Hunter, Peter M. Nardi, John L. Peterson, Anne Rivero, Gayle S. Rubin, Beth E. Schneider, and Nancy E. Stoller.
The number of disability related support services controlled and run by disabled people themselves has increased significantly in the UK and internationally over the past forty years. As a result, greater user involvement in service provision and delivery is a key priority for many western Governments. This book provides the first comprehensive review and analysis of these developments in the UK.Drawing on evidence from a range of sources, including material from the first national study of user-controlled services, this book provides a critical evaluation of the development and organisation of user-controlled services in the UK and identifies the principal forces - economic, political and cultural - that influence and inhibit their further development. It summarises and discusses the policy implications for the future development of services and includes an up-to-date and comprehensive literature and research review."Independent futures" is essential reading for academics and students on a range of courses including: health and social care; social work; allied health professions, such as nursing, occupational therapy and speech therapy; social policy; sociology; and psychology. It will also be of interest to practitioners and policy makers who need a reliable overview of current policy and critical analysis of key issues affecting future policy and practice.
Few large institutions have changed as fully and dramatically as the U.S. healthcare system since World War II. Compared to the 1930s, healthcare now incorporates a variety of new technologies, service-delivery arrangements, financing mechanisms, and underlying sets of organizing principles.
This book examines the transformations that have occurred in medical care systems in the San Francisco Bay area since 1945. The authors describe these changes in detail and relate them to both the sociodemographic trends in the Bay Area and to shifts in regulatory systems and policy environments at local, state, and national levels. But this is more than a social history; the authors employ a variety of theoretical perspectives—including strategic management, population ecology, and institutional theory—to examine five types of healthcare organizations through quantitative data analysis and illustrative case studies.
Providing a thorough account of changes for one of the nation's leading metropolitan areas in health service innovation, this book is a landmark in the theory of organizations and in the history of healthcare systems.
What do ordinary women in an African city do in the face of “serious enough” infections in themselves and signs of acute illness in their young children? How do they manage? What does it take to get by? How do they maintain the wellbeing of the household in a setting without what would be considered as basic health provision in an American or European city?
Professor Wallman focuses on women in a densely-populated part of Kampala called Kamwokya. With the help of a team of Ugandans and non-Ugandans, a vivid picture emerges, enhanced by color photographs, sketches and maps.
Women are largely responsible for the management of illness in all members of the family. Young children are at particular risk and the women have to take the first crucial decisions about treatment. Formal health resources are scarce and so they most often resort to an extraordinary range of treatments provided in the informal economy. A holistic picture of all the options that local people recognize is drawn, and an enriched understanding of problems and opportunities for health care in tropical cities emerges.
Multidisciplinary work on sexually transmitted disease is rare, even in this time of AIDS, and the book effectively maps the social contexts of its perception and management. Moreover, it focuses on women as ordinary citizens, selected by residence and not by reference to known medical conditions or high risk behavior. It is important too that the field strategies have encouraged local informants to become active participants in the definition of local problems and their solutions.
AIDS activists are often romanticized as extremely noble and selfless. However, the relationships among HIV support group members highlighted in Landscapes of Activism are hardly utopian or ideal. At first, the group has everything it needs, a thriving membership, and support from major donors. Soon, the group undergoes an identity crisis over money and power, eventually fading from the scene. As government and development institutions embraced activist demands—decentralizing AIDS care through policies of health systems strengthening—civil society was increasingly rendered obsolete. Charting this transition—from subjects, to citizens, and back again—reveals the inefficacy of protest, and the importance of community resilience. The product of in-depth ethnography and focused anthropological inquiry, this is the first book on AIDS activists in Mozambique. AIDS activism’s strange decline in southern Africa, rather than a reflection of citizen apathy, is the direct result of targeted state and donor intervention.
Edward Golub, distinguished researcher and former professor of immunology, shows that
major advances in medicine are caused by changes in the way scientists describe disease.
Bleeding, sweating, and other treatments we consider barbaric were standard treatments for
centuries because they conformed to a conception of disease shared by patients and doctors.
Scientific breakthroughs in the understanding of disease in the nineteenth century transformed
treatment and the goals of medicine. Golub argues that the ongoing revolution in molecular
genetics has opened the door to the "biology of complexity," again transforming our view of
disease. This thought-provoking, timely book reveals a crucial but overlooked role of science
in medicine, and offers a new vision for the goals of both science and medicine as we enter the
This book examines the potential of litigation as a strategy to advance the right to health by holding governments accountable for these obligations. It asks who benefits both directly and indirectly—and what the overall impacts on health equity are. Included are case studies from Costa Rica, South Africa, India, Brazil, Argentina and Colombia.
If not for the reproductive functions of women, would there be anything called women’s health care? A review of medical literature, practice, and policy in this country would suggest that the answer is no. Offering a startling view of the current state of health care for women in the United States and laying the foundation for a new, widely defined women’s medicine, Man-Made Medicine makes an urgent statement about gender bias in the medical establishment and its pernicious effects on the well-being of women and the care they receive. These essays by physicians, lawyers, activists, and scholars present a rare interdisciplinary approach to a complex set of issues. Gender stereotyping and bias in the collection, analysis, and reporting of scientific data and in the ways health-related news is covered by the media are examined. The exclusion of women from the health care policy-making process and the effect such exclusion has on the determination of priorities among potential areas of research are also explored. With discussions of the plight of specific populations of women whose health care needs are not being sufficiently met—for example, immigrants, prisoners, the mentally ill, or women with HIV/AIDS, disabilities, or reproductive health problems—this book considers matters of race and class within the parameters of gender as it builds a fundamental challenge to the existing health care system. A range of current reform proposals are also evaluated in terms of their potential impact on women. Suggesting no less than a radical rethinking of women’s medicine, Man-Made Medicine gives essential direction to the discussions that will shape the future of health care in this country. It will be of great interest to a wide audience, including health care advocates, policymakers, scholars, and readers generally concerned with women’s health issues.
Contributors. Ellen Barry, Laurie Beck, Joan Bertin, Janet Calvo, Wendy Chavkin, Kay Dickersin, Abigail English, Elizabeth Fee, Carol Gill, Nancy Krieger, Joyce McConnell, Judy Norsigian, Ann Scales, Susan Stefan, Lauren Schnaper, Catherine Teare
Measuring Functioning and Well-Being is a comprehensive account a broad range of self-reported functioning and well-being measures developed for the Medical Outcomes Study, a large-sale study of how patients fare with health care in the United States. This book provides a set of ready-to-use generic measures that are applicable to all adults, including those well and chronically ill, as well as a methodological guide to collecting health data and constructing health measures. As demand increases for more practical methods to monitor the outcomes of health care, this volume offers a timely and valuable contribution to the field. The contributors address conceptual and methodological issues involved in measuring such important health status concepts as: physical, social, and role functioning; psychological distress and well-being; general health perceptions; energy and fatigue; sleep; and pain. The authors present psychometric results and explain how to administer, score, and interpret the measures. Comprising the work of a number of highly respected scholars in the field of health assessment, Measuring Functioning and Well-Being will be of great interest and value to the growing number of researchers, policymakers, and clinicians concerned with the management and evaluation of health care.
In 1998, health expenditures in the United States accounted for 12.9% of national income-the highest share of income devoted to health in the developed world. The United States also spends more on medical research than any other country-in 2000, the federal government dedicated $18.4 billion to it, compared with only $3.7 billion for the entire European Union. In this book, leading health economists ask whether we are getting our money's worth.
From an economic perspective, they find, the answer is a resounding "yes": in fact, considering the extraordinary value of improvements to health, we may even be spending too little on medical research. The evidence these papers present and the conclusions they reach are both surprising and convincing: that growth in longevity since 1950 has been as valuable as growth in all other forms of consumption combined; that medical advances producing 10% reductions in mortality from cancer and heart disease alone would add roughly $10 trillion-a year's GDP-to the national wealth; or that the average new drug approved by the FDA yields benefits worth many times its cost of development.
The papers in this book are packed with these and many other surprising revelations, their sophisticated analysis persuasively demonstrating the massive economic benefits we can gain from investments in medical research. For anyone concerned about the cost and the value of such research-from policy makers to health care professionals and economists-this will be a landmark book.
Medical Care Output and Productivity
Edited by David M. Cutler and Ernst R. Berndt University of Chicago Press, 2001 Library of Congress RA410.5.M425 2001 | Dewey Decimal 338.433621
With the United States and other developed nations spending as much as 14 percent of their GDP on medical care, economists and policy analysts are asking what these countries are getting in return. Yet it remains frustrating and difficult to measure the productivity of the medical care service industries.
This volume takes aim at that problem, while taking stock of where we are in our attempts to solve it. Much of this analysis focuses on the capacity to measure the value of technological change and other health care innovations. A key finding suggests that growth in health care spending has coincided with an increase in products and services that together reduce mortality rates and promote additional health gains. Concerns over the apparent increase in unit prices of medical care may thus understate positive impacts on consumer welfare. When appropriately adjusted for such quality improvements, health care prices may actually have fallen. Provocative and compelling, this volume not only clarifies one of the more nebulous issues in health care analysis, but in so doing addresses an area of pressing public policy concern.
Social service agencies in the United Kingdom are increasingly under pressure to provide personalized care, even as the larger climate of austerity puts pressure on their resources. Increasingly, this means that community-based organizations of five or fewer staff members—known as microenterprises—are being asked to handle work that was formerly the province of much larger providers. In part, this is rooted in the assumption that small organizations can be more innovative and responsive. This book tests that assumption, analyzing the work of care organizations with a specific focus on size and how it affects personalization and the quality of care.
Obstetrics and Gynecology in Low-Resource Settings provides practical guidelines for ensuring quality care to women in locations where facilities are inadequate, equipment and medications are in short supply, and medical staff are few. This reference will be an essential companion to health care providers throughout the world.
On the Ragged Edge of Medicine offers a glimpse into a medical practice for the homeless and urban poor. Told through fifteen patient vignettes, and drawn from the author’s decades of experience in Portland, Oregon, this revealing memoir illuminates the impact of poverty on the delivery of health services and the ways in which people adapt and survive (or don’t survive) in conditions of abuse and deprivation. Kullberg’s stories show the direct and sometimes devastating effects of poverty on public health, poignantly demonstrating that medicine is as much a social enterprise as a scientific one.
Physicians and Hospitals addresses an issue of concern and one of fundamental importance to the American health care system. While the ranks of physicians continue to swell and hospitals continue to expand their facilities, federal, state, and local governments remain determined to control health care expenditures. As a result, checks on the supply of services and facilities have been implemented that strain the physician-hospital relationship, often placing physicians and hospital administrations in conflict. The implications for American health care are the subject of disagreement and vigorous debate.
Since recording its first AIDS cases in 1983, Tanzania has reported nearly 90,000 more to the World Health Organization—more than any other country in Africa. As AIDS spread, the devastating syndrome came to be known simply as ugonjwa huo: "that disease."
The AIDS epidemic has forced Africans to reflect upon the meaning of traditional ideas and practices related to sexuality and fertility, and upon modernity and biomedicine. In A Plague of Paradoxes, anthropologist Philip Setel observes Tanzania's Chagga people and their attempts to cope with and understand AIDS—the latest in a series of crises over which they feel they have little, if any, control.
Timely and well-researched, A Plague of Paradoxes is an extended case study of the most serious epidemic of the twentieth century and the cultural circumstances out of which it emerged. It is a unique book that brings together anthropology, demography, and epidemiology to explain how a particular community in Africa experiences AIDS.
This book examines the major phases in the history of health services in Africa and treats health as an integral aspect of the deepening crisis in Africa’s underdevelopment. One important thesis is that Western delivery systems have made health care less accessible for most people. Contributors direct attention to problems engendered by food shortages, acute cases of infection, the market in fake drugs as well as the inequality of access to facilities, the violation of human rights, and the recent danger of the dumping of toxic wastes in several African countries.
One major implication of this volume is that there can be no solution to the health crisis in Africa until the linkage between health and poverty is recognized. The authors consider questions that add to the contemporary discussion of the place that traditional African medicine and philosophy should take alongside modern Western medicine in Africa today.
This distinguished collection stands out from the recent flurry of books on health reform by its sustained and sophisticated analysis of the political dimension. In The Politics of Health Care Reform, some of America’s best-known political scientists, historians, and legal scholars make sense of our most turbulent policy issue. They dig below the jargon and minutiae to explore the enduring questions of American politics, government reform, and health care. The Politics of Health Care Reform explains how successful reforms occur in the United States and shows what is unique about health care issues. Theoretically informed, politically astute, historically nuanced, this volume takes an inventory of our health policy infrastructure. Here is an account of the institutions, ideas, and interests that shape health policy in the 1990s: Congress, the federal courts, interest groups, state governments, the public bureaucracy, business (large and small), the insurance industry, the medical profession. The volume offers a fresh look at such critical matters as public opinion, the politics of race and gender, and the lessons we can draw from other nations. The Politics of Health Care Reform is the definitive collection of political science essays about health care. Expanded from two special issues of the Journal of Health Politics, Policy and Law, the most prominent scholarly journal in the field it helped create, this collection will enliven the present debate over health reform and instruct everyone who is concerned about the future of American health care.
Contributors. Lawrence Brown, Robert Evans, William Glaser, Colleen Grogan, Robert Hackey, Lawrence Jacobs, Nancy Jecker, Taeku Lee, Joan Lehman, David McBride, Ted Marmor, Cathie Jo Martin, James A. Morone, Mark Peterson, David Rochefort, Rand Rosenblatt, David Rothman, Joan Ruttenberg, Mark Schlesinger, Theda Skocpol, Michael Sparer, Deborah Stone, Kenneth Thorpe
With the growth of parental employment, leave policy is at the centre of welfare state development and at the heart of countries' child and family policies. It is widely recognised as an essential element for attaining important demographic, social and economic goals and is the point where many different policy areas intersect: child well-being, family, gender equality, employment and labour markets, and demography. Leave policy, therefore, gives a unique insight into a country's values, interests and priorities. International comparisons of leave policy are widely available, but far less attention has been paid to understanding the factors that bring about these variations. "The politics of parental leave policies" makes good this omission. Looking at parental leave policy within a wider work/family context, it addresses how and why, and by whom, particular policies are created and subsequently developed in particular countries. Chapters covering 15 countries in Europe and beyond and the European Union bring together leading academic experts to provide a unique insight into the past, present and future state of this key policy area. "The politics of parental leave policies" is essential reading for students, teachers and researchers in social policy, child and family policy, welfare states, gender relations and equality, and employment and labour markets, providing an opportunity to study in depth the creation of social policy. It will also be of interest to policy makers in national governments and international organisations.
Since the mid-1980s, Simon Watney has been one of the leading voices in the international field of HIV/AIDS education. His monthly column on AIDS in Britain’s Gay Times is the longest-running column of its kind in Europe, and he is actively involved in HIV/AIDS issues in the United States. His work constitutes a unique dialogue between European and American perspectives on the epidemic. Practices of Freedom brings together for the first time Watney’s pioneering writings on topics ranging from gay men’s Safer Sex education to racist coverage of AIDS in Africa in the international media, from the ethics of clinical drug trials to governmental policies concerning AIDS. Watney’s voice—neither neutral nor detached—is that of an active and influential participant in the fight against AIDS. He offers a unique view of the ways in which gay men working in community-based organizations have attempted to provide reliable and up-to-date services and information regarding AIDS treatment and health. A leader in insisting on gay men’s entitlements to education, care, and services, Watney was among the first to challenge the "de-gaying" of AIDS service organizations in the late eighties. He also devotes his attention to HIV/AIDS prevention work, research and treatment issues, and the wider cultural politics of the disease, including the role of language, television, and cinema. His analysis of the epidemic as it has unfolded provides a history of many of the major medical and political debates that have defined the course and extent of the crisis. Practices of Freedom demonstrates the failure of national institutions, from the government to the press, to understand and effectively fight this epidemic, and directs attention to the most urgent needs in American and international AIDS work. It will be an important primary resource, particularly in the United States, where effective community-based HIV/AIDS education tragically has often been neglected.
Despite the attention to the problem of protecting the health care interests of Americans, there is little consensus on what should be done politically or otherwise to address this problem. In Protecting American Health Care Consumers Eleanor DeArman Kinney, a nationally regarded expert on health policy and law, tackles the serious and ongoing debate among state and federal policymakers, health care providers, third-party payers, and consumers about how to provide procedural justice to patients in the present health care climate. To promote and ensure consumer protection in an increasingly adversarial and complicated health-care culture, Kinney first analyzes the procedures by which consumer concerns are presently discerned and resolved and then explains why these systems are unsatisfactory. She also discusses problematic procedures for making coverage policy and quality standards and proposes reforms in a variety of processes that would enable all consumers, including the uninsured, to influence key policies and standards and also to raise concerns and obtain appropriate remedies. As the first comprehensive treatment of administrative procedures in American health plans and other such institutions, Protecting American Health Care Consumers will be welcomed by state and federal policymakers, managed care executives, and lawyers charged with designing and implementing protections for consumers in public and private health plans.
This book provides a scientific and personal perspective on health services research over the last half-century. Its essays and commentaries suggest how that science base, constructed over decades of sustained effort, can stimulate innovative thinking about ways to make health care systems safer, more efficient, more cost-effective, and more patient-centered.
Gus White grew up on the wrong side of the color line in Jim Crow Tennessee, then became the first black medical student at Stanford and a top surgeon at Harvard. Throughout his career he has witnessed unconscious bias against nonwhite patients. Seeing Patients shares these sobering stories and outlines concrete solutions to medical inequity.
This book uses the story of one of the authors, Gus White, as a way to talk about unconscious biases and their consequences to the medical profession and beyond. White is an orthopedic surgeon, who grew up in Tennessee under Jim Crow, went to Brown, and was the only black student at Stanford Medical School. He was the first black chief resident at Yale, the only black surgeon in Vietnam, and was the first black chief of service in a Harvard teaching hospital. His life spans an enormous change in American race relations, and he has many eye opening stories to tell. His description of his early years in an extremely segregated and racist society now reads like something from another world. White and Chanoff want to use the autobiographical approach of this book to show how great the disparities still are, and make the case for “culturally competent” medical training, in a way that is more vivid and memorable than a research review or policy paper. The book looks at White’s life, but always with an eye to what moved him to the idea of equality in medicine and problems of disparities in medicine.
The Social Medicine Reader
Gail E. Henderson Duke University Press, 1997 Library of Congress RA418.S6424 1997 | Dewey Decimal 306.461
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.
Intensive care medicine today is as close to the miraculous as most of us are likely to see in our lifetime. Nowhere is this magic more effectively practiced than in neonatal nurseries. Infants who are born prematurely at twenty-four weeks gestation and who weigh less than a pound can now be treated successfully. No other type of medicine has a more dramatic payoff, for the infants who survive can look forward to seventy or more years of life.
But there is a dark underside to the exercise of these skills. A growing number of babies live only to be tethered to life-support systems, unconscious or suffering incessant pain for years and sometimes for the duration of their lives. The ethical issues raised by these children are among the most difficult in our society. Should life be maintained no matter what its quality? Or is there a point at which treatment should be stopped on humane grounds? Who is to make decisions on continuing or ending therapy for damaged children? Is the law a suitable instrument for regulating medical decisions in intensive care nurseries? Should the growing cost of intensive care influence therapy decisions?
Special Care explores the moral and legal issues in neonatal intensive care. Fred M. Frohock spent four months in a special care nursery, observing the daily actions of doctors and nurses and interviewing staff and parents of patients. This engaging, human drama is told through the author's own journal entries interspersed with generous excerpts from taped interviews that display the practical reasoning of staff and parents as they address the moral problems raised by intensive care medicine. Several case studies of infants highlight the often contradictory directions in which medical staffs are pulled and the painful decisions that doctors and parents together are often called upon to make. The result is a book that reconstructs the ordinary life of a neonatal nursery and presents the moral views of those who are most intimately involved in therapy decisions.
This book is an urgently needed entry in the current discussions of treatment for badly damaged babies. Frohock argues that our tradition of rights language, which rests on the premise that we know what a human being is, is inappropriate when dealing with the paradoxes of decision making in neonatal nurseries. Calling for a new moral vocabulary better adapted to the world of medicine, he introduces the notion of harm in place of rights, a concept drawn from medicine's Hippocratic oath that pledges to "do no harm," as a way to begin framing questions and making decisions. Special Care will interest anyone who wants to understand medical decisions at the margins of human life.
As new medical technologies are developed, more and more human tissues—such as skin, bones, heart valves, embryos, and stem cell lines—are stored and distributed for therapeutic and research purposes. The accelerating circulation of human tissue fragments raises profound social and ethical concerns related to who donates or sells bodily tissue, who receives it, and who profits—or does not—from the transaction. Catherine Waldby and Robert Mitchell survey the rapidly expanding economies of exchange in human tissue, explaining the complex questions raised and suggesting likely developments. Comparing contemporary tissue economies in the United Kingdom and United States, they explore and complicate the distinction that has dominated practice and policy for several decades: the distinction between tissue as a gift to be exchanged in a transaction separate from the commercial market and tissue as a commodity to be traded for profit.
Waldby and Mitchell pull together a prodigious amount of research—involving policy reports and scientific papers, operating manuals, legal decisions, interviews, journalism, and Congressional testimony—to offer a series of case studies based on particular forms of tissue exchange. They examine the effect of threats of contamination—from HIV and other pathogens—on blood banks’ understandings of the gift/commodity relationship; the growth of autologous economies, in which individuals bank their tissues for their own use; the creation of the United Kingdom’s Stem Cell bank, which facilitates the donation of embryos for stem cell development; and the legal and financial repercussions of designating some tissues “hospital waste.” They also consider the impact of different models of biotechnology patents on tissue economies and the relationship between experimental therapies to regenerate damaged or degenerated tissues and calls for a legal, for-profit market in organs. Ultimately, Waldby and Mitchell conclude that scientific technologies, the globalization of tissue exchange, and recent anthropological, sociological, and legal thinking have blurred any strict line separating donations from the incursion of market values into tissue economies.
Eric Michaels Duke University Press, 1997 Library of Congress RC607.A26M53 1997 | Dewey Decimal 362.19697920092
In 1982, the American-born anthropologist Eric Michaels went to Australia to research the impact of television on remote aboriginal communities. Over the next five years, until his death, he became a major intellectual presence in Australia. Unbecoming is Michaels’s gritty, provocative, and intellectually powerful account of living with AIDS—a chronicle of the last year of his life as he became increasingly ill. Michaels’s diary offers a forceful and ironic rumination on the cultural phenomenon of AIDS, how it relates to his concerns as both an anthropologist and a gay man, and the failure of medical and governmental institutions to come to terms with the disease. Like the AIDS testimony of artist David Wojnarowicz and filmmaker Derek Jarman, Unbecoming provides a view of the AIDS epidemic from a distinctly new vantage point.
Unstable Frontiers was first published in 1994. Minnesota Archive Editions uses digital technology to make long-unavailable books once again accessible, and are published unaltered from the original University of Minnesota Press editions.
"John Erni's heartfelt and insightful book is a valuable contribution to the study of the cultural politics of AIDS."–Jeff Nunokawa Princeton University
The "cure" for AIDS: The search goes on, keeping pace with our belief that AIDS is incurable. How such a seeming paradox works-and how it may well work against the proper treatment of the disease-is the subject of Unstable Frontiers, a probing, critical look at the cultural politics behind the quest for a cure for AIDS.
This massive commercial and scientific project, John Erni suggests, actually hinges on our contradictory definitions of the disease as curable and incurable at the same time. Drawing on diverse sources, from popular media to medical literature to cultural theory, he shows how the dual discourse of curability/incurability frames the way we think about and act on issues of medical treatment for AIDS. His work makes a major advance in our understanding of—and, perhaps, humane response to—a national crisis.
In his critique of the logic and fantasies underlying the double definition of AIDS, Erni explores a broad range of issues: the scientific paradigm used to develop AZT; the politics of alternative treatment practices, of clinical drug trials, and of AIDS activism; and the notions of time and temporality operating in AIDS treatment science. He also addresses the problematic popular themes, such as "AIDS is invariably fatal" and "Knowledge = Cure."
Unique in its approach to a social and political issue still in the making, the book reveals how AIDS has challenged technomedicine's historical position of authority-and in doing so, recasts this challenge in a powerful and ultimately hopeful way.
John Nguyet Erni is assistant professor of communication at the University of New Hampshire. He has published essays on AIDS and is currently working on a book about AIDS in Thailand.