The Social Medicine Reader

"A wonderful collection that in its impressive breadth and depth gives a full account of a nation's contemporary medicine as it has been shaped by the events of the late 20th century."--Robert Coles

Preface ixIntroduction 1Part I. A Cultural Perspective of Experiences of Illness, Disability, nd DevianceIntroduction / Sue Estroff 61. Culture, Health, and Illness 12The Nature of Suffering and the Goals of Medicine / Eric J. Cassell 13Cancer, Control, and Causality: Talking about Cancer in a Working-Class Community / Martha Belshem 23Coming to Terms with Advanced Breast Cancer: Black Women's Narratives from Eastern North Carolina / Holly F. Matthews, Donald R. Lannin, and James P. Mitchell 432. Illness Experiences and Illness Narratives 61The Deer at Providencia / Annie Dillard 63The Cost of Appearances / Arthur Frank 66Silver Water / Amy Bloom 693. Experiences of Deviance, Chronic Illness, and Disability 75Self, Identity, and the Naming Question: Reflections on the Language of Disability / Irving Kenneth Zola 77Finch the Spastic Speaks / Gordon Weaver 87Tell Me, Tell Me / Irving Kenneth Zola 95Part II. The Influence of Social Factors on Health and IllnessIntroduction / Gail E. Henderson 1001. The Relationship between Social Class, Race/Ethnicity, and Health 108Socioeconomic Inequalities in Health: No Easy Solution / Nancy E. Adler 109"Where Crowded Humanity Suffers and Sickens": The Banes Family and Their Neighborhood / Laurie K. Abraham 121One Drop of Blood / Lawrence Wright 1312. Gender and Health 142Women Have Headaches, Men Have Backaches: Patterns of Illness in an Appalachian Community / Claire F. Horton 143Spence + Lila (excerpts) / Bobbie Ann Mason 156The Mother-in-Law / Doris Betts 1633. Old Age 167Trends, Issues, Perspectives, and Values for the Aging of the Baby Boom Cohorts (excerpts) / John M. Cornman and Eric R. Kingson 168What Do Children Owe Elderly Parents? / Daniel Callahan 175Decision Making, Responsibility, and Advocacy in Geriatric Medicine: Physician Dilemmas with Elderly in the Community / Sharon R. Kaufman 184We Are Nighttime Travelers / Ethan Canin 196Part III. The Culture of Medicine and Medical PracticeIntroduction / Ronald P. Strauss 205The Socialization of Physicians 209Basic Clinical Skills: The First Encounters / Melvin Konner 210Becoming a Doctor: Critical-Incident Reports from Third-Year Medical Students / William Branch, Richard J. Pels, Robert S. Lawrence, and Ronald Arky 223Invasions / Perri Klass 227Ethical Dilemmas fro House Staff Physicians: The Care of Critically Ill and Dying Patients / William Winkenwerder Jr. 230A Student's View of a Medical Teaching Exercise / Abenaa Brewster 236The Libby Zion Case: One Step Forward or Two Steps Backward? / David A. Asch and Ruth M. Parker 2382. Medical Practice in Social Context 244Presidential Address: The Boundaries of Medicine / Donald W. Seldin 244The Boundaries of Medicine / Gerald T. Perkoff 254The Changing Demography of the Medical Profession / Arnold S. Relman 263Medicine is No Longer a Man's Profession: Or, When the Men's Club Goes Coed It's Time to Change the Regs / Carola Eisenberg 266The Doctors of Hoyland / Sir Arthur Conan Doyle 2703. Relationships between Doctors and Patients 277The Basic Models of the Doctor-Patient Relationship / Thomas S. Szasz and Marc H. Hollender 278Facing Our Mistakes / David Hilfiker 287Simple Living and Hard Choices / Maureen A. Flannery 293The Paid Nurse / William Carlos Williams 300Part IV. Health Care Ethics and the Provider's RoleIntroduction / Nancy M. P. King 3041. The Provider-Patient Relationship 309Bioethics in Social Context / Larry R. Churchill 310The Use of Force / William Carlos Williams 320Case Study: The "Student Doctor" and a Wary Patient / Marc D. Basson, Gerald Dworkin, and Eric J. Cassell 323Truth Telling to the Patient / Antonella Surbone 326Is Truth Telling to the Patient a Cultural Artifact? / Edmund D. Pellegrino 330Offering Truth: One Ethical Approach to the Uninformed Cancer Patient / Benjamin Freedman 333What the Doctor Said / Raymond Carver 341Informed Consent, Cancer, and Truth in Prognosis / George J. Annas 341Swapping Stories: A Matter of Ethics / Judith Andre 346Case Study: Please Don't Tell / Leonard Fleck and Marcia Angell 3492. Interests in Conflict 353Cesareans and Samaritans / Nancy K. Rhoden 354Justified Limits on Refusing Intervention / Frank A. Chervenak and Laurence B. McCullough 365Faith (Healing), Hope, and Charity at the FDA: The Politics of AIDS Drug Trials / George J. Annas 375Case Study: The Doctor's Unproven Beliefs and the Subjects Informed Choice / Don Marquis 3863. Choices about Treatment 391Disconnecting a Ventilator at the Request of a Patient Who Knows He Will Then Die: The Doctor's Anguish / Miles J. Edwards and Susan W. Tolle 393The Last Words of My English Grandmother / William Carlos Williams 398Death and Dignity: A Case of Individualized Decision Making / Timothy E. Quill 399Informed Demand for "Non-Beneficial" Medical Treatment / Steven H. Miles 403The Case of Helga Wanglie: A New Kind of "Right to Die" Case / Marcia Angell 407Part V. Medical Care Financing, Rationing, and Managed CareIntroduction / Larry R. Churchill 4101. Medical Care Financing 415Paying for Medical Care in America / Donald L. Madison 415Reforming the Health Care System: The Universal Dilemma / Uwe E. Reinhardt 4462. Rationing: The Dilemmas of Fair Distribution 460The "Rationing" of Medical Care / Victor R. Fuchs 461The Prostitute, the Playboy, and the Poet: Rationing Schemes for Organ Transplantation / George J. Annas 464Ethics of Queuing for Coronary Artery Bypass Grafting in Canada / Jafna L. Cox 469Rationing in Practice: The Case of In Vitro Fertilisation / Sharon Redmayne and Rudolf Klein 4753. Managed Care and the Physician's Changing Role 481Hippocrates and the Health Maintenance Organization: A Discussion of Ethical Issues / Gail Povar and Jonathan Moreno 482Physicians and Business Managers: A Clash of Cultures / Arnold S. Relman 491Preserving the Physician-Patient Relationship in the Era of Managed Care / Ezekiel J. Emanuel and Nancy Neveloff Dubler 495Bibliography 510Acknowledgment of Copyrights 514Index to Authors 517