The Social Medicine Reader

by Henderson, Gail E.; King, Nancy M. P.; Strauss, Ronald P.; Estroff, Sue E.; Churchill, Larry R.

• ISBN13: 9780822319573
• ISBN10: 0822319578
• Format: Hardcover
• Copyright: 1997-06-01
• Publisher: Duke Univ Pr

Summary

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 Readeris 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 Readerdefines the meaning of the social medicine perspectiveandoffers 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 byThe 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 providerrs"s role, medical care financing, rationing, and managed care.

Table of Contents

Preface	ix
Introduction	1	(5)
PART I A CULTURAL PERSPECTIVE OF EXPERIENCES OF ILLNESS, DISABILITY, AND DEVIANCE	6	(94)
Introduction	6	(6)
Sue E. Estroff
1 Culture, Health, and Illness	12	(49)
The Nature of Suffering and the Goals of Medicine	13	(10)
Eric J. Cassell
Cancer, Control, and Causality: Talking about Cancer in a Working-Class Community	23	(20)
Martha Balshem
Coming to Terms with Advanced Breast Cancer: Black Women's Narratives from Eastern North Carolina	43	(18)
Holly F. Mathews
Donald R. Lannin
James P. Mitchell
2 Illness Experiences and Illness Narratives	61	(14)
The Deer at Providencia	63	(3)
Annie Dillard
The Cost of Appearances	66	(3)
Arthur Frank
Silver Water	69	(6)
Amy Bloom
3 Experiences of Deviance, Chronic Illness, and Disability	75	(25)
Self, Identity, and the Naming Question: Reflections on the Language of Disability	77	(10)
Irving Kenneth Zola
Finch the Spastic Speaks	87	(8)
Gordon Weaver
Tell Me, Tell Me	95	(5)
Irving Kenneth Zola
PART II THE INFLUENCE OF SOCIAL FACTORS ON HEALTH AND ILLNESS	100	(105)
Introduction	100	(8)
Gail E. Henderson
1 The Relationship between Social Class, Race/Ethnicity, and Health	108	(34)
Socioeconomic Inequalities in Health: No Easy Solution	109	(16)
Nancy E. Adler et al.
"Where Crowded Humanity Suffers and Sickens": The Banes Family and Their Neighborhood	121	(10)
Laurie K. Abraham
One Drop of Blood	131	(11)
Lawrence Wright
2 Gender and Health	142	(25)
Women Have Headaches, Men Have Backaches: Patterns of Illness in an Appalachian Community	143	(13)
Claire F. Horton
Spence + Lila (excerpts), Bobbie Ann Mason	156	(7)
The Mother-in-Law	163	(4)
Doris Betts
3. Old Age	167	(38)
Trends, Issues, Perspectives, and Values for the Aging of the Baby Boom Cohorts (excerpts)	168	(7)
John M. Cornman
Eric R. Kingson
What Do Children Owe Elderly Parents?	175	(9)
Daniel Callahan
Decision Making, Responsibility, and Advocacy in Geriatric Medicine: Physician Dilemmas with Elderly in the Community	184	(12)
Sharon R. Kaufman
We Are Nighttime Travelers	196	(9)
Ethan Canin
PART III THE CULTURE OF MEDICINE AND MEDICAL PRACTICE	205	(99)
Introduction	205	(4)
Ronald P. Strauss
1 The Socialization of Physicians	209	(35)
Basic Clinical Skills: The First Encounters	210	(13)
Melvin Konner
Becoming a Doctor: Critical-Incident Reports from Third-Year Medical Students	223	(4)
William Branch
Richard J. Pels
Robert S. Lawrence
Ronald Arky
Invasions	227	(3)
Perri Klass
Ethical Dilemmas for House Staff Physicians: The Care of Critically Ill and Dying Patients	230	(6)
William Winkenwerder Jr.
A Student's View of a Medical Teaching Exercise	236	(2)
Abenaa Brewster
The Libby Zion Case: One Step Forward or Two Steps Backward?	238	(6)
David A. Asch
Ruth M. Parker
2 Medical Practice in Social Context	244	(33)
Presidential Address: The Boundaries of Medicine	244	(10)
Donald W. Seldin
The Boundaries of Medicine	254	(9)
Gerald T. Perkoff
The Changing Demography of the Medical Profession	263	(3)
Arnold S. Relman
Medicine Is No Longer a Man's Profession; Or, When the Men's Club Goes Coed It's Time to Change the Regs	266	(4)
Carola Eisenberg
The Doctors of Hoyland	270	(7)
Sir Arthur Conan Doyle
3 Relationships between Doctors and Patients	277	(27)
The Basic Models of the Doctor-Patient Relationship	278	(9)
Thomas S. Szasz
Marc H. Hollender
Facing Our Mistakes	287	(6)
David Hilfiker
Simple Living and Hard Choices	293	(7)
Maureen A. Flannery
The Paid Nurse	300	(4)
William Carlos Williams
PART IV HEALTH CARE ETHICS AND THE PROVIDER'S ROLE	304	(106)
Introduction	304
Nancy M. P. King
1 The Provider-Patient Relationship	309	(44)
Bioethics in Social Context	310	(10)
Larry R. Churchill
The Use of Force	320	(3)
William Carlos Williams
Case Study: The "Student Doctor" and a Wary Patient	323	(3)
Marc D. Basson
Gerald Dworkin
Eric J. Cassell
Truth Telling to the Patient	326	(4)
Antonella Surbone
Is Truth Telling to the Patient a Cultural Artifact?	330	(3)
Edmund D. Pellegrino
Offering Truth: One Ethical Approach to the Uninformed Cancer Patient	333	(8)
Benjamin Freedman
What the Doctor Said	341	(1)
Raymond Carver
Informed Consent, Cancer, and Truth in Prognosis	341	(5)
George J. Annas
Swapping Stories: A Matter of Ethics	346	(3)
Judith Andre
Case Study: Please Don't Tell!	349	(4)
Leonard Fleck
Marcia Angell
2 Interests in Conflict	353	(38)
Cesareans and Samaritans	354	(11)
Nancy K. Rhoden
Justified Limits on Refusing Intervention	365	(10)
Frank A. Chervenak
Laurence B. McCullough
Faith (Healing), Hope, and Charity at the FDA: The Politics of AIDS Drug Trials	375	(11)
George J. Annas
Case Study: The Doctor's Unproven Beliefs and the Subject's Informed Choice	386	(5)
Don Marquis et al.
3 Choices about Treatment	391	(19)
Disconnecting a Ventilator at the Request of a Patient Who Knows He Will Then Die: The Doctor's Anguish	393	(5)
Miles J. Edwards
Susan W. Tolle
The Last Words of My English Grandmother	398	(1)
William Carlos Williams
Death and Dignity: A Case of Individualized Decision Making	399	(4)
Timothy E. Quill
Informed Demand for "Non-Beneficial" Medical Treatment	403	(4)
Steven H. Miles
The Case of Helga Wanglie: A New Kind of "Right to Die" Case	407	(3)
Marcia Angell
PART V MEDICAL CARE FINANCING, RATIONING, AND MANAGED CARE	410	(100)
Introduction	410	(5)
Larry R. Churchill
1 Medical Care Financing	415	(45)
Paying for Medical Care in America	415	(31)
Donald L. Madison
Reforming the Health Care System: The Universal Dilemma	446	(14)
Uwe E. Reinhardt
2 Rationing: The Dilemmas of Fair Distribution	460	(21)
The "Rationing" of Medical Care	461	(3)
Victor R. Fuchs
The Prostitute, the Playboy, and the Poet: Rationing Schemes for Organ Transplantation	464	(5)
George J. Annas
Ethics of Queuing for Coronary Artery Bypass Grafting in Canada	469	(6)
Jafna L. Cox
Rationing in Practice: The Case of In Vitro Fertilisation	475	(6)
Sharon Redmayne
Rudolf Klein
3 Managed Care and the Physician's Changing Role	481	(29)
Hippocrates and the Health Maintenance Organization: A Discussion of Ethical Issues	482	(9)
Gail Povar
Jonathan Moreno
Physicians and Business Managers: A Clash of Cultures	491	(4)
Arnold S. Relman
Preserving the Physician-Patient Relationship in the Era of Managed Care	495	(5)
Ezekiel J. Emanuel
Nancy Neveloff Dubler
Bibliography	510	(4)
Acknowledgment of Copyrights	514	(3)
Index to Authors	517