Coming from diverse backgrounds—economics, law, political science, and the health care industry itself—the contributors use Arrow’s article to address a range of present-day health-policy questions. They examine everything from health insurance and technological innovation to the roles of charity, nonprofit institutions, and self-regulation in addressing medical needs. The collection concludes with a new essay by Arrow, in which he reflects on the health care markets of the new millennium. At a time when medical costs continue to rise, the ranks of the uninsured grow, and uncertainty reigns even among those with health insurance, this volume looks back at a seminal work of scholarship to provide critical guidance for the years ahead.
Contributors
Linda H. Aiken
Kenneth J. Arrow
Gloria J. Bazzoli
M. Gregg Bloche
Lawrence Casalino
Michael Chernew
Richard A. Cooper
Victor R. Fuchs
Annetine C. Gelijns
Sherry A. Glied
Deborah Haas-Wilson
Mark A. Hall
Peter J. Hammer
Clark C. Havighurst
Peter D. Jacobson
Richard Kronick
Michael L. Millenson
Jack Needleman
Richard R. Nelson
Mark V. Pauly
Mark A. Peterson
Uwe E. Reinhardt
James C. Robinson
William M. Sage
J. B. Silvers
Frank A. Sloan
Joshua Graff Zivin
Undead Science examines the story of cold fusion, one of the most publicized scientific controversies of the late twentieth century. In 1989 two Utah-based “discoverers” claimed to have developed an electrochemical process that produced more energy than was required to initiate the process. Finding no other explanation, the researchers described their findings as some kind of nuclear reaction. If they were correct, an important new energy source would have been found. Objections surfaced quickly, and in the year that followed, hundreds of scientists worldwide attempted to reproduce these results. Most, though not all, failed, and the controversy became increasingly antagonistic. By 1990, general scientific opinion favored the skeptics and experimental work went into a steep decline. Nevertheless, many scientists continue to do research in what Bart Simon calls this “undead science.”
Simon argues that in spite of widespread skepticism in the scientific community, there has been a continued effort to make sense of the controversial phenomenon. Researchers in well-respected laboratories continue to produce new and rigorous work. In this manner, cold fusion research continues to exist long after the controversy has subsided, even though the existence of cold fusion is circumscribed by the widespread belief that the phenomenon is not real.
The survival of cold fusion signals the need for a more complex understanding of the social dynamics of scientific knowledge making, the boundaries between experts, intermediaries, and the lay public, and the conceptualization of failure in the history of science and technology.
Most women who elect to have cosmetic surgery want a “natural” outcome—a discrete alteration of the body that appears unaltered. Under the Knife examines this theme in light of a cultural paradox. Whereas women are encouraged to improve their appearance, there is also a stigma associated with those who do so via surgery.
Samantha Kwan and Jennifer Graves reveal how women negotiate their “unnatural”—but hopefully (in their view) natural-looking—surgically-altered bodies. Based on in-depth interviews with 46 women who underwent cosmetic surgery to enhance their appearance, the authors investigate motivations for surgery as well as women’s thoughts about looking natural after the procedures. Under the Knife dissects the psychological and physical strategies these women use to manage the expectations, challenges, and disappointments of cosmetic surgery while also addressing issues of agency and empowerment. It shows how different cultural intersections can produce varied goals and values around body improvement.
Under the Knife highlights the role of deep-seated yet contradictory gendered meanings about women’s bodies, passing, and boundary work. The authors also consider traditional notions of femininity and normalcy that trouble women’s struggle to preserve an authentic moral self.
Every year, about forty million Americans require surgery. Few truly understand what happens to them during the procedure-especially what the anesthesiologist does to ensure their survival and well being. An anesthesiologist disarms your entire nervous system with the most effective drugs for your body chemistry; keeps you alive while you're subjected to manipulations that would otherwise kill you; and ensures your safe return to consciousness. Yet despite their crucial role, anesthesiologists are often the unseen doctors. Under the Mask, written by a compassionate practitioner, demystifies the surgical process with detailed information that will make you a better-informed consumer.
Part One describes the development and current scope of anesthesiology, the medications and techniques used, and what the anesthesiologist does both in and outside the operating room. It explains your-the patient's- rights and advises you how to use the preoperative consultation with the anesthesiologist to your best advantage, specifying what information you need provide and what questions you should ask.
Part Two details the most common surgical and diagnostic procedures requiring anesthesia or conscious sedation. Using clear language, it explains each procedure, the possible risks, and the choices to make if there is more than one option. It also covers the anesthesiologist's crucial role in controlling pain caused by chronic conditions. The last chapter describes the newest anesthetic and pain control techniques available.
The author also helps you understand anesthesiology within the managed care system and explains what you can expect and what to do if you aren't getting what you need. This book enables you to make informed decisions regarding surgical anesthesia and subsequent pain control within the managed care system to protect your well-being and hasten your recovery.Assisted suicide remains one of the most emotionally charged and controversial topics—and the issue isn’t going away any time soon. As the baby boomer generation ages, many of us will watch as our parents—and ourselves—grow older, and wonder at the decisions that lie ahead.
Understanding Assisted Suicide provides both a fresh take on this important topic and the framework for intelligent participation in the discussion. Uniquely, the author frames the issue using his own experience watching both his parents die, which led him to ask fundamental questions about death, dying, religion, and the role of medicine and technology in alleviating human suffering.
In concerns about assisted suicide, each person’s “big picture” has largely been created out of picking and choosing from nine separate snapshot albums.
Understanding this offers a perspective for quickly determining the sources of another’s opinion on assisted suicide, as well as the issues they are not considering. Most importantly, Understanding Assisted Suicide offers a clear, easy-to-traverse landscape over which those who are sincerely looking for their own answers can navigate. The “nine-issue structure” allows both careful exploration of separate issues and a view of the full spectrum of ideas involved.
Self-help groups have encountered fierce criticism as places where individuals join to share personal problems and to engage in therapeutic intervention without the aid of skilled professionals. These groups have flourished since the 1970s and continue to serve more people than professional therapy.
Yet these groups have been criticized as fostering a culture of whiners and victims, and not using professional help as needed. Thomasina Jo Borkman debunks this commonly held assessment, and also examines the reasons for these groups’ enduring popularity since the 1960s—more people attend these meetings (word?) than see professional therapists. What accounts for their success and popularity?
Understanding Self-Help / Mutual-Aid Groups is the first book to describe three stages of individual and group evolution that is part of this organization’s very structure; it also reconceptualizes participants’ interactions with professionals. The group as a whole, Borkman posits, draws on the life experiences of its membes to foster nurturing, support, and transformation through a “circle of sharing.” Groups create more positive and less stigmatizing “meaning perspectives” of the members’ problems than is available from professionals or lay folk culture.
Developing a cybernetic model of subjectivity and personhood that honors disability experiences to reconceptualize the category of the human
Twentieth-century neuroscience fixed the brain as the basis of consciousness, the self, identity, individuality, even life itself, obscuring the fundamental relationships between bodies and the worlds that they inhabit. In Unraveling, Matthew J. Wolf-Meyer draws on narratives of family and individual experiences with neurological disorders, paired with texts by neuroscientists and psychiatrists, to decenter the brain and expose the ableist biases in the dominant thinking about personhood.
Unraveling articulates a novel cybernetic theory of subjectivity in which the nervous system is connected to the world it inhabits rather than being walled off inside the body, moving beyond neuroscientific, symbolic, and materialist approaches to the self to focus instead on such concepts as animation, modularity, and facilitation. It does so through close readings of memoirs by individuals who lost their hearing or developed trauma-induced aphasia, as well as family members of people diagnosed as autistic—texts that rethink modes of subjectivity through experiences with communication, caregiving, and the demands of everyday life.
Arguing for a radical antinormative bioethics, Unraveling shifts the discourse on neurological disorders from such value-laden concepts as “quality of life” to develop an inclusive model of personhood that honors disability experiences and reconceptualizes the category of the human in all of its social, technological, and environmental contexts.
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.
This book describes the emergence of a small but essential medical specialty, urology, at one of the first American public institutions of higher education, the University of Michigan. Urology at Michigan: The Origin Story, a microcosm of the modern world of healthcare specialization, entwines many stories beginning with its earliest roots, diagnostic uroscopy and the primitive interventions of catheterization and lithotomy. The Hippocratic Oath forbade its generalist healers from only three practices – abortion, euthanasia, and lithotomy, relegating the last to specialists “in that art,” namely itinerant lithotomists of whom little record remains. Over two and a half millennia since Hippocrates, catheterization, lithotomy, and genitourinary surgery in general advanced only modestly until products of the industrial revolution and scientific inquiry provided the tools and knowledge that accelerated the ancient genitourinary work into a new discipline of urology around the fin de siècle of the 19th century, just as the University of Michigan concurrently was joining the top rank of higher education.
The University of Michigan in the early 20th century was nearly a century old and contained a medical school and wholly-owned University Hospital, the first of that genre. Ann Arbor was a propitious place for modern urology to take hold when Hugh Cabot brought not just the new terminology, but also the complete triple mission with urologic education and research embedded in a milieu of world-class clinical care. Cabot arrived in Ann Arbor from Boston in the autumn of 1919, imbued with more than two years’ service in WWI with the British Expeditionary Forces on the Western Front, and he became Dean of the Medical School in 1921. Cabot expanded the full-time salary model in the medical school, supervised construction of Ann Arbor’s 4th iteration of the University Hospital, but its first state-of the art facility. He created a multi-specialty academic group practice and assembled a great faculty with future leaders in surgery including Frederick Coller, Max Peet, Carl Badgley, and John Alexander. Cabot’s first trainees to become urologists were Charles Huggins, a future Nobel Laureate, and Reed Nesbit who rose to the top ranks of academic and organizational urology and made Ann Arbor an international clinical and educational destination. This book tells the story of urology at Michigan amidst the larger stories of the roots of genitourinary surgery, the formation of the University of Michigan and its Medical School, and the inevitable tensions of balancing the triple mission of medical academia: education and investigation within a milieu of the essential transaction of excellent clinical care.READERS
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