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Doctors, scientists, and patients have long grappled with the dubious nature of “certainty” in medical practice. To help navigate the chaos caused by ongoing bodily change we rely on scientific reductions and deductions. We take what we know now and make best guesses about what will be. But bodies in flux always outpace the human gaze. Particularly in cancer care, processes deep within our bodies are at work long before we even know where to look. In the face of constant biological and technological change, how do medical professionals ultimately make decisions about care?

Bodies in Flux explores the inventive ways humans and nonhumans work together to manufacture medical evidence. Each chapter draws on rhetorical theory to investigate a specific scientific method for negotiating medical uncertainty in cancer care, including evidential visualization, assessment, synthesis, and computation. Case studies unveil how doctors rely on visuals when deliberating about a patient’s treatment options, how members of the FDA use inferential statistics to predict a drug’s effectiveness, how researchers synthesize hundreds of clinical trials into a single evidence-based recommendation, and how genetic testing companies compute and commoditize human health. Teston concludes by advocating for an ethic of care that pushes back against the fetishization of certainty—an ethic of care that honors human fragility and bodily flux.

Iatrogenesis is the occurrence of untoward effects resulting from actions of health care providers, including medical errors, medical malpractice, practicing beyond one’s expertise, adverse effects of medication, unnecessary treatment, inappropriate screenings, and surgical errors. This is a huge public health issue: tens to hundreds of thousands of deaths are attributed to iatrogenic causes each year in the U.S., and vulnerable populations such as the elderly and minorities are particularly susceptible. 

Edited by two renowned cardiology experts, Iatrogenicity: Causes and Consequences of Iatrogenesis in Cardiovascular Medicine addresses both the iatrogenicity that arises with cardiovascular interventions, as well as non-cardiovascular interventions that result in adverse consequences on the cardiovascular system. The book aims to achieve three things: to summarize the available information on this topic in a single high-yield volume; to highlight the human and financial cost of iatrogenesis; and to describe and propose potential interventions to ameliorate the effects of iatrogenesis. This accessible book is a practical reference for any practicing physician who sees patients with cardiovascular issues. .
 

How are human subjects treated in biomedical research? What are the expressed standards and self-reported behavior of biomedical researchers in regard to what has sometimes been called their "animal of necessity"? What are some of the determinants of the "strict" and "permissive" patterns which describe the standards and behavior of biomedical researchers? These are the important questions asked and answered in Research on Human Subjects. It is a book based on four years of intensive research. Two studies were completed, one on a nationally representative sample of biomedical research institutions, a second on a sample of 350 researchers who actually use human subjects. In their chapters on "the dilemma of science and therapy," the authors look at the tension between the values of humane therapy and discovery in science. They show that the significant minority of researchers who are "permissive" on the issues of informed consent and a favorable risk-benefit ratio are more likely to be those who are "relative failures" in pursuing the science value. Research on Human Subjects also documents the inadequate training that biomedical researchers get in the ethics of research on human subjects not only in medical schools but in their postgraduate training as well. The medical schools pay relatively more attention to the scientific training of their students than they do to the ethical training that should be its essential complement. The local peer review groups that screen research on human subjects in the institutions where it is carried on are another central focus of attention of the research and analysis reported in this book. The peer review groups do a fairly good job but, the authors show, there are various conditions of their relative efficacy which are not met by review groups in many important research institutions. The medical school review groups, for example, have not been outstanding performers with respect to the several conditions of relative efficacy. In the concluding chapter, the authors discuss the general problem of the social responsibilities of powerful professions and make very specific suggestions for policy change and reform for the biomedical research profession and its use of human subjects.

Few things make people react more strongly to the changes going on in health care than the word standardization. Critics shudder at the mindless sameness of standards, while supporters dream of a world in which standardized "best practices" open up a world of efficient health care delivery. The Gold Standard takes up this debate to investigate the real meaning of standardization and how it affects patients, doctors, and the institution of medicine. Showing that standards are not about less or more skills, or more or less uniformity, but rather about a redefinition of autonomy, patients, and relationships, Timmermans and Berg show instead that they are about creating new worlds of medical treatment. Cutting through the hype and fears, the authors show where the true powers of standardization lie. The Gold Standard will become a classic for students of medicine and health care policy, and will be a welcome book for anyone concerned with the future of our system of care.

Winner of the 2008 Arthur J. Viseltear Prize from the American Public Health Association and Nominated for the 2008 William H. Welch Medal, AAHM

Though notorious for its polluted air today, the city of Los Angeles once touted itself as a health resort. After the arrival of the transcontinental railroad in 1876, publicists launched a campaign to portray the city as the promised land, circulating countless stories of miraculous cures for the sick and debilitated. As more and more migrants poured in, however, a gap emerged between the city’s glittering image and its dark reality.

            Emily K. Abel shows how the association of the disease with “tramps” during the 1880s and 1890s and Dust Bowl refugees during the 1930s provoked exclusionary measures against both groups. In addition, public health officials sought not only to restrict the entry of Mexicans (the majority of immigrants) during the 1920s but also to expel them during the 1930s. 

            Abel’s revealing account provides a critical lens through which to view both the contemporary debate about immigration and the U.S. response to the emergent global tuberculosis epidemic.