This insightful study examines the deeply personal and heart-wrenching tensions among financial considerations, emotional attachments, and moral arguments that motivate end-of-life decisions.
America’s health care system was built on the principle that life should be prolonged whenever possible, regardless of the costs. This commitment has often meant that patients spend their last days suffering from heroic interventions that extend their life by only weeks or months. Increasingly, this approach to end-of-life care is coming under scrutiny, from a moral as well as a financial perspective. Sociologist Roi Livne documents the rise and effectiveness of hospice and palliative care, and growing acceptance of the idea that a life consumed by suffering may not be worth living.
Values at the End of Life combines an in-depth historical analysis with an extensive study conducted in three hospitals, where Livne observed terminally ill patients, their families, and caregivers negotiating treatment. Livne describes the ambivalent, conflicted moments when people articulate and act on their moral intuitions about dying. Interviews with medical staff allowed him to isolate the strategies clinicians use to help families understand their options. As Livne discovered, clinicians are advancing the idea that invasive, expensive hospital procedures often compound a patient’s suffering. Affluent, educated families were more readily persuaded by this moral calculus than those of less means.
Once defiant of death—or even in denial—many American families and professionals in the health care system are beginning to embrace the notion that less treatment in the end may be better treatment.
Aging and cancer may be manifestations of genetic, or epigenetic, changes in somatic cells. Through research, laboratory analysis of these related processes has become possible. Cells can be removed from the body, kept warm in laboratory glassware, nourished by artificial solutions, and studied for years, or even decades. Two types of cultures have emerged: Primary cultures, grown from cells obtained directly from living animals, may grow well for generations, but ultimately cease to divide. Established cultures, on the other hand, may grow and divide indefinitely. It is a striking fact that most, if not all, established cultures consist of cells that are heteroploid, having an abnormal chromosome complement that may include structural rearrangements as well as abnormalities of chromosome number.
Most established cultures are also neoplastic on behavior and morphology—in this, they resemble cancers—and established cultures are, in fact, often grown from cancer cells. Interest in the role of chromosomes in neoplasia has recently been overshadowed by an emphasis on tumor viruses. This book should reawaken the former interest. It will also arouse new interest in the role of epigenetic mechanisms of animal cells, in contrast to the classic genetic processes. As Dr. John Littlefield writes: “The relationship between the overcoming of senescence, the appearance of heteroploidy, and the acquisition of neoplastic qualities is not yet clear, but it is of such great theoretical and practical importance as to demand attention and new ideas.”
Veins of Devotion details recent collaborations between guru-led devotional movements and public health campaigns to encourage voluntary blood donation in northern India. Focusing primarily on Delhi, Jacob Copeman carefully situates the practice within the context of religious gift-giving, sacrifice, caste, kinship, and nationalism. The book analyzes the operations of several high-profile religious orders that organize large-scale public blood-giving events and argues that blood donation has become a site not only of frenetic competition between different devotional movements, but also of intense spiritual creativity.
Despite tensions between blood banks and these religious groups, their collaboration is a remarkable success storyùthe nation's blood supply is replenished while blood donors discover new devotional possibilities.
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“In recent decades, the deficiencies of our system of medical education and medical care have become clearer and more comprehensible to an expanding and highly vocal segment of the public. Many educators share the uneasiness and recognize the need for change.” These words from Dr. John Knowles's Preface define the context of this collection of thought-provoking essays, originally presented in 1966 as a series of lectures sponsored jointly by the Lowell Institute of Boston and Massachusetts General Hospital.
Written by seven men distinguished in the fields of medicine, education, and government, they are addressed to everyone, expert and layman alike, concerned with the quality of medical care in the United States. The ultimate aim of medicine is to enhance the quality of life by the prevention of disease and the comprehensive care of the sick. Technological advances continually provide us with new and better tools, but medicine is plagued by rising costs, inefficient use of facilities and personnel, and critical shortages of manpower. Each author, from his particular point of view, recognizes the need to bring medicine into contact with the social sciences, and presents concrete proposals for government aid and curriculum reform.
Viruses are the most abundant biological entities on Earth, and arguably the most successful. They are not technically alive, but—as infectious vehicles of genetic information—they have a remarkable capacity to invade, replicate, and evolve within living cells. Synthesizing a large body of recent research, Michael Cordingley goes beyond our familiarity with viral infections to show how viruses spur evolutionary change in their hosts, shape global ecosystems, and influence every domain of life.
In the last few decades, research has revealed that viruses are fundamental to the photosynthetic capacity of the world’s oceans and the composition of the human microbiome. Perhaps most fascinating, viruses are now recognized as remarkable engines of the genetic innovation that fuels natural selection and catalyzes evolution in all domains of life. Viruses have coevolved with their hosts since the beginning of life on our planet and are part of the evolutionary legacy of every species that has ever lived.
Cordingley explains how viruses are responsible for the creation of many feared bacterial diseases and the emergence of newly pathogenic and drug-resistant strains. And as more and more viruses jump to humans from other animals, new epidemics of viral disease will threaten global society. But Cordingley shows that we can adapt, relying on our evolved cognitive and cultural capacities to limit the consequences of viral infections. Piecing together the story of viruses’ major role within and beyond human disease, Viruses creates a valuable roadmap through the rapidly expanding terrain of virology.
Homeopathy, as a medical system, presented a significant institutional and economic challenge to conventional medicine in the nineteenth century. Although contemporary critics portrayed homeopathic physicians as part of a sect whose treatment of disease was beyond the pale of acceptable medical practice, homeopathy was in many ways similar to established medicine. Anne Taylor Kirschmann explores the strategic choices and consequences for women practitioners. Not only were female homeopaths respected within their communities, they also enjoyed considerable professional advantages not available to women within regular medicine.
A Vital Force: Women in American Homeopathy offers a new interpretation of women’s roles in modern medicine. Kirschmann strengthens and clarifies the history of homeopathic women physicians and creates a framework of comparison to “regular,” or orthodox, physicians. Women medical practitioners chose homeopathy in dramatic numbers from the mid-nineteenth through the early twentieth centuries, although the reasons for this preference varied over time. Linked to social reform movements in the nineteenth century, anti-modernism in the late nineteenth and early twentieth, and countercultural ideals of the 1960s and 1970s, women's advocacy of homeopathy has been intertwined with broad social and cultural issues in American society.
"Have you taken your vitamins today?" That question echoes daily through American households. Thanks to intensive research in nutrition and medicine, the importance of vitamins to health is undisputed. But millions of Americans believe that the vitamins they get in their food are not enough. Vitamin supplements have become a multibillion-dollar industry. At the same time, many scientists, consumer advocacy groups, and the federal Food and Drug Administration doubt that most people need to take vitamin pills.
Vitamania tells how and why vitamins have become so important to so many Americans. Rima Apple examines the claims and counterclaims of scientists, manufacturers, retailers, politicians, and consumers from the discovery of vitamins in the early twentieth century to the present. She reveals the complicated interests--scientific, professional, financial--that have propelled the vitamin industry and its would-be regulators. From early advertisements linking motherhood and vitamin D, to Linus Pauling's claims for vitamin C, to recent congressional debates about restricting vitamin products, Apple's insightful history shows the ambivalence of Americans toward the authority of science. She also documents how consumers have insisted on their right to make their own decisions about their health and their vitamins.
Vitamania makes fascinating reading for anyone who takes--or refuses to take--vitamins. It will be of special interest to students, scholars, and professionals in public health, the biomedical sciences, history of medicine and science, twentieth-century history, nutrition, marketing, and consumer studies.
Winner of the Organization for the Study of Communication, Language, and Gender 2013 Outstanding Book Award
Winner of the 2013 Bonnie Ritter Book Award from the Feminist and Women's Division of the National Communication Association
The feminist women’s health movement of the 1960s and 1970s is credited with creating significant changes in the healthcare industry and bringing women’s health issues to public attention. Decades later, women’s health issues are more visible than ever before, but that visibility is made possible by a process of depoliticization
The Vulnerable Empowered Woman assesses the state of women’s healthcare today by analyzing popular media representations—television, print newspapers, websites, advertisements, blogs, and memoirs—in order to understand the ways in which breast cancer, postpartum depression, and cervical cancer are discussed in American public life. From narratives about prophylactic mastectomies to young girls receiving a vaccine for sexually transmitted disease, the representations of women’s health today form a single restrictive identity: the vulnerable empowered woman. This identity defuses feminist notions of collective empowerment and social change by drawing from both postfeminist and neoliberal ideologies. The woman is vulnerable because of her very femininity and is empowered not to change the world, but to choose from among a limited set of medical treatments.
The media’s depiction of the vulnerable empowered woman’s relationship with biomedicine promotes traditional gender roles and affirms women’s unquestioning reliance on medical science for empowerment. The book concludes with a call to repoliticize women’s health through narratives that can help us imagine women—and their relationship to medicine—differently.
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