Instances of euthanasia or mercy killing date back to antiquity. However, it is only recently that the unprecedented grassroots efforts to legalize euthana sia have begun building. "Terminal Illness, Assistance with Dying," a California ballot initiative for the No vember 1992 election, might for the first time in modem history legalize euthanasia and assisted suicide by physicians. Similar initiatives are planned in other states. To vote intelligently, citizens in California and throughout the United States need to learn who is likely to request euthanasia or assisted suicide, and why. How we care for the terminally ill eventually af fects us all. In over half of all deaths, a chronic dis ease process such as cancer or congestive heart failure leads to a terminal phase that may last for days, weeks, or months. Most people are more afraid of the suffering associated with this terminal phase than they are afraid of dying itself. When polled, most Americans tell us they would prefer to die at home, surrounded by loved ones, rather than in a hospital receiving high-tech tests and treatments until the last. Yet the majority of people, even those with term inal illnesses, die in the hospital. What factors in our culture and health care system have led to this dichotomy? Unrelieved suffering is also the primary reason for euthanasia requests."

Improving partnership working between health and social care agencies has long been a feature of government policy but has recently gained increased impetus as a result of New Labour's commitment to joined-up government. This book provides a detailed but accessible introduction to policy and practice at the interface between health and social care. Drawing on key research, government policies and real-life case studies, the book assists health and social care professionals to work more effectively together in order to improve services for users and carers. The health and social care divide: explains why partnerships are important and what helps or hinders partnership working; reviews the legal and policy framework, providing a chronological overview and placing current initiatives in their historical and social policy context; summarises existing research findings with regard to key health and social care policy debates; uses case studies to explore the implications of this research for health and social care practitioners; provides good practice guidance for both students and frontline practitioners. The book is designed as an introductory text for those working or training to work in a multi-agency environment. In particular, it will be of interest to social work, nursing, therapy and medical students, frontline practitioners and those undertaking post-qualification training courses.

Most Latin American countries are now attempting the radical reform of their healthcare financing and delivery systems. In many cases, these reforms complement and contribute to broader neo-liberal orthodoxies of economic and social reform. Key strategies include decentralising hospital administration and the promotion of private health insurance. However, experiences across the region are quite diverse, and countries such as Cuba persist with a system of healthcare based on very different principles. This book identifies key problems facing healthcare systems in the region and evaluates the reforms that have been implemented to date. It pays particular attention to problems of implementation and the impact that changes to health policy are having on poor and vulnerable groups.

This book provides the first in-depth study of healthcare reforms in post-communist Eastern Europe. Combining insights from comparative politics and public policy analysis, it examines health reforms in Slovenia, the Czech Republic, and Poland between 1989 and 2019. The book argues that the post-communist transformation of healthcare policy has entailed a process of policy learning, and that the countries' reform pathways were shaped by a series of initiatives aimed at applying market-oriented policy ideas in healthcare. The success of these initiatives has been influenced by three factors: policy legacies, political competition, and institutional configurations. The book offers a novel comparison of health reform in the region and policy changes more generally. It will appeal to scholars and students of public policy, health policy, and European politics.

With sixteen hospitals and almost 10,500 beds, the New York City Health and Hospitals Corporation(HHC) is the largest municipal hospital system in the United States. With forty-seven hospitals and almost thirty-three thousand beds, the Paris Hospital Corporation, Assistance Publique-Hopitaux de Paris(AP), is three times as large, the biggest municipal hospital system in France.

This book compares these two vast systems. It analyzes staffing, outpatient and inpatient care, the desirability of private faculty practice plans, budgeting, quality assurance, and the role of medical education in these two very different systems. In addition, it reviews how both HHC and AP plan to adapt their systems over the next decade and beyond. Aging populations, the development and diffusion of new medical technologies, and the growth of hospitals and physicians throughout the 1960s and 1970s have led to massive increases in health care costs in both the United States and in France. Both New York City and Paris have suffered the shock of the AIDS epidemic. Detailed, informed, and authoritative, this book will stand for years as " the " standard comparative study of two large municipal hospital systems.

"Providing a comprehensive picture of diversity, ethnicity, and migration in the health sector this book analyses the key themes of career and career structures, social processes, segregation, racism and sexism at international, national and local levels"--

This work presents an approach derived from direct participant observation of small units within institutions, all in the health and social services sector. A range of contributors bring together the results of their own observational projects - in settings as diverse as a mental hospital canteen, an acute psychiatric admission ward and a palliative care unit - to show how they were able to come to a psychoanalytically informed understanding of the cultures that arise within healthcare organizations, and how this understanding can be used to overcome difficulties that arise. This work should help healthcare workers, teachers and managers better understand the functioning and difficulties of their organizations and therefore help in the management and practice of the work.

Between 1990 and 1993, breast cancer activism became a significant political movement. The issue began to receive extensive media attention, and federal funding for breast cancer research jumped dramatically. Describing the origins of this surge in interest, Maureen Hogan Casamayou attributes it to the emergence of politically potent activism among breast cancer survivors and their supporters. Exploring the creation and development of the National Breast Cancer Coalition (NBCC), she shows how many of its key leaders were mobilized by their own traumatic experiences with the disease and its treatments.

Casamayou details the NBCC's meteoric rise and impressive lobbying efforts, explaining how -- in contrast to grassroots movements founded by dedicated individuals -- the coalition grew from the simultaneous efforts of a network of women who invested their time, energy, money, and professional skills in the fight for increased funding for breast cancer research. This multiple leadership -- or collective entrepreneurialism, says Casamayou -- was crucial to the NBCC's success framing the issue in the minds of the public and policymakers alike.

This book presents some of the most recent research results on the applications of computational intelligence in healthcare. The contents include: information model for management of clinical content; state-based model for management of type II diabetes; case-based reasoning in medicine; assessing the quality of care in AI environment; electronic medical record to examine physician decisions; multi-agent systems for the management of community healthcare; assistive wheelchair navigation; and more.

Blockchain technology (BT) is quietly transforming the world, from financial infrastructure, to the internet-of-things, to healthcare applications. With increasing penetration of BT into various areas of our daily lives, the need arises for better awareness and greater knowledge about the capabilities, benefits, risks, and alternatives to distributed ledger applications. It is hoped that current book will be one of the pioneering collections focusing on blockchain implementations in the area of healthcare, with specific aim to present content in an easy-to-understand and readily accessible way for typical end-users of blockchain-based applications. There are important areas within the fabric of modern healthcare that stand to benefit from implementations of BT. These areas include electronic medical records, quality control, patient safety, finance, device tracking, biostamping/biocertification, redundant storage of critical data, health and liability insurance, medication utilization tracking (including opioid and antibiotic misuse), financial transactions, academics/education, asset tokenization, public health and pandemics, healthcare provider credentialing, and many other potential applications. The ultimate goal of the proposed book would be to provide an integrative, easy-to-understand, and comprehensive picture of the current state of blockchain use in healthcare while actively engaging the reader in a forward-looking, exploratory approach toward future developments in this space. To accomplish this goal, an expert panel of contributors has been assembled, featuring scholars from top global universities and think-tanks.

This remarkable text raises the analysis of data in health sciences and policy to new heights of refinement and applicability by introducing cutting-edge meta-analysis strategies while reviewing more commonly used techniques. Each chapter builds on sound principles, develops methodologies to solve statistical problems, and presents concrete applications used by experienced medical practitioners and health policymakers. Written by more than 30 celebrated international experts, Meta-Analysis in Medicine and Health Policy employs copious examples and pictorial presentations to teach and reinforce biostatistical techniques more effectively and poses numerous open questions of medical and health policy research.

Why some patients wait longer than others remains an important question. This book is a reference for health services researchers looking for statistical tools with which to study waiting times. The book offers detailed coverage of statistical concepts and methods for the analysis and interpretation of waiting-time data. It provides analysis from health services research perspective, rather than operations management, and contains a collection of examples.

Hospitals, medical practices and healthcare organizations are implementing new technologies at breakneck speed. Yet privacy and security considerations are often an afterthought, putting healthcare organizations at risk of data security and privacy issues, fines, damage to their reputations, with serious potential consequences for the patients. Electronic Health Record systems (EHRs) consist of clinical notes, patient listings, lab results, imaging results and screening tests. EHRs are growing in complexity over time and requiring increasing amounts of data storage. With the development of the IoT, the Cloud and Smart Cities frameworks, new privacy and security methods are being pursued to secure healthcare-based systems and platforms. Presenting a detailed framework as well as comparative case studies for security protection, data integrity, privacy preservation, scalability, and healthcare legislation, this edited volume covers state of the art research and addresses privacy and security methods and technologies for EHRs.

A beautifully illustrated history of Britain’s most revered and valued institution: the NHS. In March 2020 the UK went into lockdown to help contain the spread of COVID-19 and protect the NHS from one of the greatest threats that it has faced in its 72-year history. Today more than ever, all eyes are on this beloved institution as it continues to innovate and adapt to meet the challenges of providing national healthcare in the modern world. In this fully illustrated introduction, Dr Susan Cohen traces the history of the NHS from its establishment after the Second World War, through seven decades of changing management and organisation, often in controversial political circumstances, right up to the current COVID-19 crisis. Including personal recollections from healthcare professionals on the frontline, as well as the patients in their care, this important and timely volume offers a comprehensive overview of one of the world's most remarkable healthcare systems.

Discover how gay men 's health care can be improved Smearing the Queer: Medical Bias in the Health Care of Gay Men explores how social prejudices embedded in scientific research and practice often act as a detriment to gay men 's health. This book provides an agenda for addressing heterosexism in the health sciences and in medical care while broadening approaches to gay male wellness beyond the limited scope of HIV infection. This groundbreaking book explore a number of neglected concerns affecting the sexual health of gay men, calling for the recognition of their scientific, political, and cultural significance. In Smearing the Queer, gay men, HIV prevention workers, health care providers, mental health professionals, policymakers, researchers, and instructors in related fields will appreciate the in-depth examination of such issues as: research and development on rectal microbicides why many gay men should be receiving periodic anal Pap smears to screen for anorectal cancer an in-depth critique of the problematic diagnosis of "Gay Bowel Syndrome" gay men 's use of the Reality Female Condom for anal sex Viagara 's impact on gay men 's sexual cultures, erectile dysfunction, and recreational drug use a broad-based advocacy agenda for improving relations between gay men and the health sciences the politics surrounding gay men 's restricted access to new and prospective safer sex technologies Smearing the Queer challenges heterosexist bias within the health care delivery and health sciences research and calls for the development of public policy initiatives that address gay men 's wellness in more sophisticated and complex ways. This is the only publication that provides in-depth social, cultural, and political analysis of the topics of Gay Bowel Syndrome, gay men 's use of the female condom, rectal microbicides, and anal Pap smears while examining the social forces that direct scientific research under the guise of objectivity.

Health and the American Indian discusses contemporary health and social concerns in American Indian communities and offers recommendations for prevention, treatment, and future research. You?ll benefit from recent research that examines topics relating to physical and mental health, such as health care, gambling, historical trauma response, child welfare, and Native American involvement in the Human Genome Diversity Project. In Health and the American Indian, you?ll find cutting-edge information about various concerns in American Indian society that will assist you in offering culturally sensitive services to clients. Using in-depth studies and statistics to highlight issues facing Native Americans, this book provides you with an understanding of American Indian views on family, health, and being Native American. With Health and the American Indian, you?ll find suggestions and methods to sharpen your service skills, including: exploring differences in the historical trauma response between men and women to effectively treat both groups investigating the positive and negative effects that gambling has had on members of the community by using Grounded Theory combating problems related to gambling by redistributing a percentage of gaming income towards gaming abuse prevention and treatment programs, traditional community activities, and child care participating in continuing education or in-service training on cultural issues and understanding a client's cultural background in order to better help clients utilize the benefits of the Indian Child Welfare Act using the Family Systems approach along with community health representatives in health care interventions to provide better health care for Native AmericansExploring the topic of genetic engineering, Health and the American Indian discusses the Human Genome Diversity Project, gene patents, and how Native Americans who supply genetic material are being exploited and see no compensation for their assistance. Examining how exploitation and fear stand in the way of better physical and mental well-being, Health and the American Indian offers you methods and suggestions to help prevent and improve existing health issues in Native American communities.

This book examines how Botswana overcame the legacies of exceptional resource deficiency, colonial neglect and a harsh physical environment to transform itself from one of the poorest nations of the world to a middle income economy with significant reductions in people's poverty. It reviews the interactions of economic, social and institutional policies and how these reinforced one another to produce the poverty outcomes that they did from the initial socio-economic conditions. In particular it illustrates how the chosen development strategies consistently tied social and economic policies to achieve, on the one hand, re-distribution, protection and reproduction and, on the other, investment in production and human capabilities. The substantive areas covered include trends in economic development strategies and outcome; social policies and strategies and their impact on poverty and productive capacity; income and wealth distribution; the role of organized interest groups in policy development; and institutional development, state capacity and politics.

After World War II, the United States and Canada, two countries that were very similar in many ways, struck out on radically divergent paths to public health insurance. Canada developed a universal single-payer system of national health care, while the United States opted for a dual system that combines public health insurance for low-income and senior residents with private, primarily employer-provided health insurance - or no insurance - for everyone else.In "National Health Insurance in the United States and Canada", Gerard W. Boychuk probes the historical development of health care in each country, honing in on the most distinctive social and political aspects of each country - the politics of race in the U.S. and territorial politics in Canada especially the tensions between the national government and the province of Quebec. In addition to the politics of race and territory, Boychuk sifts through the numerous factors shaping health policy, including national values, political culture and institutions, the power of special interests, and the impact of strategic choices made at critical junctures. Drawing on historical archives, oral histories, and public opinion data, he presents a nuanced and thoughtful analysis of the evolution of the two systems, compares them as they exist today, and reflects on how each is poised to meet the challenges of the future.

Dramatic changes to the structure of health systems since the 1980s has seen the development of large, integrated health organizations designed to provide scale and scope advantages, improve the quality of care and health outcomes, and provide greater bargaining power relative to payers and large employers. This transition has led to greater interest in understanding hospitals and health systems as complex systems. Two important themes emerged from this effort: 1. Creation and organization of physician-health organizations, and alignment of these organizations with hospital or system structure; and 2. Viewing health care organizations as complex systems, leading to new perspectives on design and management of these organizations. In Volume 15, Reuben McDaniel and L. Robert Burns, authors of two influential articles on these themes from earlier volumes of AHCM, revisit the evolution of health systems organization in light of regulatory and organizational evolution in health care, including the Patient Protection and Accountable Care Act of 2010, and increasing consolidation of health systems. Five additional refereed papers assess the latest evidence on physician integration, complexity, and system redesign.

This 26th volume in the Research in Economic Anthropology series differs in two main ways from all those that have come before. For one, it is the first REA volume to focus exclusively on the issue of health. In addition, it is not as concerned overall with economic or social theory, or with economic reasoning and action, as other volumes have been. Rather, it concentrates on the identification and analysis of important economic factors in the production of health and wellness. The volume consists of ten original anthropological papers that explore the general theme of the economics of health and wellness in a variety of ways. Some of these papers are more strongly ethnographic in nature, relying wholly on qualitative data derived from participant-observer methods at which ethnographers excel. Other papers successfully blend such information with quantitative data drawn from surveys, questionnaires, and even from biological samples. All papers, however, are grounded in empirical methods and based on data drawn from the personal investigations of the authors. Subjects and geographic areas represented in the volume are: 1) Lakota residents of the Pine Ridge Indian Reservation in South Dakota, USA, 2) rural people of Bangladesh, 3) mental health care facilities and systems in Texas, USA, 4) unsuccessful rural-urban migrants in Botswana, Southern Africa, 5) loggers in British Columbia, Canada, 6) municipal bus drivers in San Francisco, California, 7) poor residents of Puebla, Mexico, 8) slum dwellers of Lima, Peru, 9) female victims of domestic abuse in Northern Vietnam, and 10) followers of Tibetan Buddhism in France.
*Original articles written by experts in theirfields
*International in scope

This book offers a bio-psycho-social approach to evidence-based practice in health and social care. The book presents current evidence on the influence of genetic, epigenetic and environmental factors on behaviour, a survey of developmental factors from childhood to old age, and implications for practice at each stage.

In the 1960s, feminists voiced their outrage about the health care system in the United States which routinely discriminated against women and, in so doing, literally jeopardized their health and well-being. Over a decade later, women's health advocates still stressed the need for reform of this male-dominated institution because of the on-going threat to the health of American women. In the 1990s, nearly 40 years after women began their fight for quality and equitable treatment from the medical profession, women unfortunately continue to confront problems on numerous levels including discrimination in medical research and in the availability of insurance and health care providers. Most alarming, however, is the fact that women today--like women in the '60s and before--lack information, understanding, and adequate diagnoses and treatment from their health caregivers.
This book extends from a program of research on women's health issues by the authors. More than 150 audio-taped, naturally occurring interactions between health caregivers and their female patients from three different health care settings--as well as ethnographic field notes in three additional settings which provide health care to women-- constitute the data for this investigation. They explore the consequentiality of relational issues during women's health care encounters and examine how health care participants save face, enact roles, co-construct their encounters, and accomplish the objective of education and medical care.
Unlike earlier works, this study utilizes an extensive data collection derived directly from hundreds of interactions between health care providers and their patients, as opposed to surveys or case studies of singular practitioners. The authors examine the data in light of insights from a variety of theoretical perspectives and are committed to exploring the implication that medical encounters are collaboratively managed by both patients and caregivers. Given these theoretical and empirical contributions, the authors believe this book will advance present understanding in the areas of health and relational communication, women's health care, gender issues in communication, conversation analysis, discourse processes, and institutional talk.

A unique historical review that traces health spending from ancient times to the present and forecasts 21st century trends. There are many histories of medicine, yet none that assess the dynamics of expenditures over decades and centuries. Economists have not yet addressed the magnitude of the transformation that occurred during the twentieth century as payments shifted from solo physician practices to health systems, nor the legacy effects of social practices accumulated over millennia that will shape health spending in the twenty-first. In Money and Medicine, Thomas E. Getzen provides a unified narrative of medical spending from ancient Egypt and Babylonia to the present day. Drawing on a wealth of historical reports, data, and documents, Getzen concentrates on a single ratio-the share of income devoted to medical care-to frame the evolutionary path of medicine, revealing an S-shaped growth curve that rose rapidly after 1900 as science made therapies more effective and more expensive, inflected as national health systems coalesced and rates of expansion peaked in the 1960s, then decelerated after 1975. International trends in forty-three countries are graphically illustrated with analysis supporting a parsimonious financial model. Significant lags are seen between medical innovation or macroeconomic shocks and the corresponding changes in national health expenditures. Getzen explains inertial responses to the 2008 financial crisis and Covid-19 recession, provides a method for projecting trends over the next fifty years, and suggests why spending is so much higher in the United States than other countries. As rising costs and unequal distribution of medical care have created a sense of crisis in many countries, Money and Medicine shows that we must look beyond the last few years to craft sensible solutions.