No other book in the field so fully combines vivid clinical examples, specific details of technique, and mature perspectives on both effectively functioning families and those seeking therapy. The views and strategies of a master clinician are presented here in such clear and precise form that readers can proceed directly from the book with comparisons and modifications to suit their own styles and working situations.

Salvador Minuchin presents six chapter-length transcripts of actual family sessions—two devoted to ordinary families who are meeting their problems with relative success; four concerned with families seeking help. Accompanying each transcript is the author’s running interpretation of what is taking place, laying particular stress on the therapist’s tactics and maneuvers.

These lively sessions are interpreted in a brilliant theoretical analysis of why families develop problems and what it takes to set them right. The author constructs a model of an effectively functioning family and defines the boundaries around its different subsystems, whether parental, spouse, or sibling. He discusses ways in which families adapt to stress from within and without, as they seek to survive and grow.

Dr. Minuchin describes methods of diagnosing or “mapping” problems of the troubled family and determining appropriate therapeutic goals and strategies. Different situations, such as the extended family, the family with a parental child, and the family in transition through death or divorce, are examined. Finally, the author explores the dynamics of change, examining the variety of restructuring operations that can be employed to challenge a family and to change its basic patterns.

Through an intensive clinical study of forty incest victims and numerous interviews with professionals in mental health, child protection, and law enforcement, Judith Herman develops a composite picture of the incestuous family. In a new afterword, Herman offers a lucid and thorough overview of the knowledge that has developed about incest and other forms of sexual abuse since this book was first published.

Reviewing the extensive research literature that demonstrates the validity of incest survivors' sometimes repressed and recovered memories, she convincingly challenges the rhetoric and methods of the backlash movement against incest survivors, and the concerted attempt to deny the events they find the courage to describe.

A Few Months to Live describes what dying is like from the perspectives of nine terminally ill individuals and their caregivers. Documenting a unique study of end-of-life experiences that included detailed conversations in home care settings, the book focuses on how participants lived their daily lives, understood their illnesses, coped with symptoms-especially pain-and searched for meaning or spiritual growth in their final months of life. The accounts are presented largely in the participants' own words, illuminating both the medical and non-medical challenges that arose from the time each learned the "bad news" through their final days of life and memorial services.

Describing the nationwide crisis that surrounds end-of-life care, the authors contend that informal caregiving by relatives and close friends is an enormous and too-often invisible resource that deserves close and public attention. By incorporating not only the ill person's but also the family's perspective, they portray the nine participants in the contexts of their daily lives and relationships rather than simply as patients. Addressing such issues as palliative care, quality of life, financial hardship, grief and loss, and communications with medical personnel, the authors identify how families, professionals, and communities can respond to the challenges of terminal illness and the need to confront life's end.

Barbara Stafford is a pioneering art historian whose research has long helped to bridge the divide between the humanities and cognitive sciences. In A Field Guide to a New Meta-Field, she marshals a distinguished group of thinkers to forge a ground-breaking dialogue between the emerging brain sciences, the liberal arts, and social sciences.

Stafford’s book examines meaning and mental function from this dual experimental perspective. The wide-ranging essays included here—from Frank Echenhofer’s foray into shamanist hallucinogenic visions to David Bashwiner’s analysis of emotion and danceability—develop a common language for implementing programmatic and institutional change. Demonstrating how formerly divided fields are converging around shared issues, A Field Guide to a New Meta-Field maps a high-level, crossdisciplinary adventure from one of our leading figures in visual studies.

Among the most serious challenges facing health systems in lower and middle income countries is establishing efficient, fair, and sustainable financing mechanisms that offer universal protection. Lack of financial protection forces families to suffer the burden not only of illness but also of economic ruin and impoverishment. In Latin America, financial protection for health continues to be segmented and fragmented; health is mainly financed through out-of-pocket payments.

Financing Health in Latin America presents new and important insight into the crucial issue of financial protection in health systems. The book analyzes the level and determinants of catastrophic health expenditures among households in Argentina, Brazil, Chile, Colombia, Costa Rica, the Dominican Republic, Mexico, and Peru, applying both descriptive and econometric analyses. The results demonstrate that out-of-pocket health spending is pushing large segments of the population into impoverishment and that the poorest and most vulnerable segments of the population are most at risk of financial catastrophe. This work is a product of the collaboration between more than 25 researchers and 18 institutions associated with the Research for Health Financing in Latin America and the Caribbean Network, with support from the International Development Research Centre of Canada.

    First, Do No Harm shows how health care professionals, with the best intentions of providing excellent, holistic health care, can nonetheless perpetuate violence against vulnerable patients. The essays investigate the need to rethink contemporary healthcare practices in ways that can bring the art and science of medicine back into sorely needed balance.
    These ground-breaking studies by noted scholars question commonly held assumptions in contemporary healthcare that underlie oppressive power dynamics and even violence for patients and their families. The contributors discuss such topics as women and violence, life-support technologies, and healthcare professionals’ own experiences as patients. First, Do No Harm opens the discourse for reaching new understandings, from reassessing the meaning of "quality of life" to questioning the appropriateness of the very language used by healthcare professionals. It will be welcomed by healthcare workers and by scholars in nursing, medicine, and the allied health sciences.

Medical care prices in the United States are not only the most expensive in the world, but there are wide variations in what physicians are paid. Doctors at the frontlines of medical care who manage complex conditions argue that they receive disproportionately lower fees than physicians performing services such as minor surgeries and endoscopies. Fixing Medical Prices goes to the heart of the U.S. medical pricing process: to a largely unknown yet influential committee of medical organizations affiliated with the American Medical Association that advises Medicare. Medicare’s ready acceptance of this committee’s recommendations typically sets off a chain reaction across the entire American health care system.

For decades, the U.S. policymaking structure for pricing has reflected the influence of physician organizations. What Miriam Laugesen’s rich analysis shows is how these organizations navigate the arcane and complex work of this advisory committee. Contradicting the story of a profession in political decline, Fixing Medical Prices demonstrates that the power of physician organizations has simply become more subtle.

Laugesen’s investigation into the exorbitant cost of American medical care will be of interest to those who follow the politics of health care policy, the influence of interest groups on rate setting, and the medical profession’s past and future role in our health care system.

Here is a brief but comprehensive tour of the physiology of vision, guided by one of the grand masters of the discipline. Offering first a solid grounding in structure and function, the book emphasizes those areas that the author considers to be of most significance in current research. Much attention is given to the role of vision in circadian timekeeping, the development of the visual system, the effect of aging on the eye, and the provocative questions of perception and illusion.

An eminently readable text, Focus on Vision will more than satisfy the needs of students in ophthalmology, optometry, physiological optics, biology, psychology, and art. It is fully illustrated and contains lists of references and further reading. The questions at the end of each chapter may be used to test understanding or simply to excite discussion.

Winner of the Margaret W. Rossiter History of Women in Science Prize

A new history uncovers the crucial role women played in the great transformations of medical science and health care that accompanied the Italian Renaissance.

In Renaissance Italy women played a more central role in providing health care than historians have thus far acknowledged. Women from all walks of life—from household caregivers and nurses to nuns working as apothecaries—drove the Italian medical economy. In convent pharmacies, pox hospitals, girls’ shelters, and homes, women were practitioners and purveyors of knowledge about health and healing, making significant contributions to early modern medicine.

Sharon Strocchia offers a wealth of new evidence about how illness was diagnosed and treated, whether by noblewomen living at court or poor nurses living in hospitals. She finds that women expanded on their roles as health care providers by participating in empirical work and the development of scientific knowledge. Nuns, in particular, were among the most prominent manufacturers and vendors of pharmaceutical products. Their experiments with materials and techniques added greatly to the era’s understanding of medical care. Thanks to their excellence in medicine urban Italian women had greater access to commerce than perhaps any other women in Europe.

Forgotten Healers provides a more accurate picture of the pursuit of health in Renaissance Italy. More broadly, by emphasizing that the frontlines of medical care are often found in the household and other spaces thought of as female, Strocchia encourages us to rethink the history of medicine.

The largest unmet health need in this country—and potentially the most costly—is for dental care; meeting this need would strain existing personnel and facilities beyond capacity. This book reports an experiment in delivering dental care by means that are not traditional but preserve the high standards that have been achieved by American dentistry.

At the Forsyth Dental Center in Boston, Massachusetts, graduate dental hygienists received additional training in the administration of local anesthesia, drilling decayed teeth, and filling them. The program was designed to prepare dental auxiliaries to undertake restorative treatment under the direct supervision of a dentist who assumes ultimate responsibility for planning treatment, assessing the quality of performance, and assuring the patient's well-being.

The Forsyth experiment yielded information on the competence of auxiliaries trained in this fashion, on patient acceptance, on the efficiency of various patterns of practice, and on the potential economic effects of delivering care in this way. The results of the study are bound to stir controversy, but they cannot be ignored by anyone who cares about a major problem in health care.

So many women who do everything right to stay healthy still wind up with breast cancer, heart disease, or osteoporosis. In The Fragile Wisdom, Grazyna Jasienska provides an evolutionary perspective on the puzzle of why disease prevention among women is so frustratingly difficult. Modern women, she shows, are the unlucky victims of their own bodies’ conflict of interest between reproductive fitness and life-long health.

The crux of the problem is that women’s physiology has evolved to facilitate reproduction, not to reduce disease risk. Any trait—no matter how detrimental to health in the post-reproductive period—is more likely to be preserved in the next generation if it increases the chance of giving birth to offspring who will themselves survive to reproductive age. To take just one example, genes that produce high levels of estrogen are a boon to fertility, even as they raise the risk of breast cancer in mothers and their daughters.

Jasienska argues that a mismatch between modern lifestyles and the Stone Age physiology that evolution has bequeathed to every woman exacerbates health problems. She looks at women’s mechanisms for coping with genetic inheritance and at the impact of environment on health. Warning against the false hope gene therapy inspires, Jasienska makes a compelling case that our only avenue to a healthy life is prevention programs informed by evolutionary understanding and custom-fitted to each woman’s developmental and reproductive history.

Both communitarianism and casuistry have sought to restore ethics as a practical science—the former by incorporating various traditions into a shared definition of the common good, the latter by considering the circumstances of each situation through critical reasoning.

Mark G. Kuczewski analyzes the origins and methods of these two approaches and forges from them a new unified approach. This approach takes the communitarian notion of the person as its starting point but also relies upon the narrative and analogical tools of case-based reasoning. He separates out the rhetoric that is incongruent with the Aristotelian aspirations of each method to show that the two are complementary, and that consensus can emerge from fragmentation.

He then applies his resulting method to three major problems in bioethics: the difficulties that the issue of personal identity poses for advance directives, the role of the family in medical decision making, and the refusal of treatment because of religious beliefs. He analyzes the need to assume a communitarian notion of the person as a starting point for the application of casuistic insights.

Combining theoretical, practical, and scholarly insights, this book will be of interest to philosophers, political and social scientists, and bioethicists.

In a remarkable synthesis of the research of the last two decades, a leading developmental neuroscientist provides psychologists with a sophisticated introduction to the brain—the system that underpins the functions that they study.

In clear terms, with ample illustrations, Joan Stiles explains the complexities of genetic variation and transcription, and the variable paths of neural development, from embryology through early childhood. She describes early developmental processes from gene expression to physiology to behavior. Sections on clinical correlations show the consequences for later physiological, neurological, or psychological disturbances in neural development.

As Stiles shows, brain development is far more complex and dynamic than is often assumed in debates about nature vs. nurture, nativism vs. cultural learning. Inherited and experienced factors interact constantly in an ever-changing organism. The key question is, what developmental processes give rise to particular structures or mechanisms?

A landmark of synthesis and interdisciplinary illumination, The Fundamentals of Brain Development will enrich discussion of developmental processes and more rigorously define the terms that are central to psychological debates.

Americans are understandably concerned about the runaway costs of medical care and the fact that one citizen out of seven is without health insurance coverage. Solving these problems is a top priority for the Clinton administration, but as Victor Fuchs shows, the task is enormously complex. In this book Fuchs, America's foremost health economist, provides the reader with the necessary concepts, facts, and analyses to comprehend the complicated issues of health policy. He shows why health care reform that benefits society as a whole will unavoidably burden certain individuals and groups.

Fuchs addresses such central questions as cost containment, managed competition, technology assessment, poverty and health, children's health, and national health insurance. The future of U.S. health policy, he argues, is tightly linked to three basic questions; First, how can we disengage health insurance from employment? Second, how can we tame technological change in health care? And finally how can we cope with the runaway medical costs of an aging society?