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Books > Medicine > General
CATHOLIC PERSPECTIVES AND CONTEMPORARY MEDICAL MORALS A Catholic
perspective on medical morals antedates the current world wide
interest in medical and biomedical ethics by many centuries 5].
Discussions about the moral status of the fetus, abortion,
contraception, and sterilization can be found in the writings of
the Fathers and Doctors of the Church. Teachings on various aspects
of medical morals were scattered throughout the penitential books
of the early medieval church and later in more formal treatises
when moral theology became recog nized as a distinct discipline.
Still later, medical morality was incorpor ated into the many
pastoral works on medicine. Finally, in the contemporary period,
works that strictly focus on medical ethics are produced by
Catholic moral theologians who have special interests in matters
medical. Moreover, this long tradition of teaching has been put
into practice in the medical moral directives governing the
operation of hospitals under Catholic sponsorship. Catholic
hospitals were monitored by Ethics Committees long before such
committees were recommended by the New Jersey Court in the Karen
Ann Quinlan case or by the President's Commission in 1983 ( 8, 9]).
Underlying the Catholic moral tradition was the use of the
casuistic method, which since the 17th and 18th centuries was
employed by Catholic moralists to study and resolve concrete
clinical ethical dilem mas. The history of casuistry is of renewed
interest today when the case method has become so widely used in
the current revival of interest in medical ethics ll]."
Medicine, morals and money have, for centuries, lived in uneasy
cohabitation. Dwelling in the social institution of care of the
sick, each needs the other, yet each is embarrassed to admit the
other's presence. Morality, in particular, suffers embarrassment,
for it is often required to explain how money and medicine are not
inimical. Throughout the history of Western medicine, morality's
explanations have been con sistently ambiguous. Pla.o held that the
physician must cultivate the art of getting paid as well as the art
of healing, for even if the goal of medicine is healing and not
making money, the self-interest of the craftsman is satisfied
thereby [4]. Centuries later, a medieval medical moralist, Henri de
Mandeville, said: "The chief object of the patient ... is to get
cured ... the object of the surgeon, on the other hand, is to
obtain his money ... ([5], p. 16). This incompatibility, while
general, is not universal. Throughout history, medical
practitioners have resolved the problem - either in conscience or
to their satisfaction. Some physicians have been so reluctant to
make a profit from the ills of those whom they treated that they
preferred to live in poverty. Samuel Johnson described his friend,
Dr. Robert Levet, a Practiser of Physic: No summons mock'd by chill
delay, No petty gain disdain'd by pride; The modest wants of ev'ry
day The toil of ev'ry day supplied [3].
This book has been specifically designed to help GP trainees pass
the compulsory AKT examination. Each topic has been skilfully
refined to correlate directly with primary care and the RCGP
curriculum, revealing how and why critical appraisal and evidence
based medicine are essential for good medical practice throughout a
career as an independent, knowledgeable, caring and thoughtful
general practitioner. It includes invaluable preparation
suggestions and an overall outline of the AKT, an introduction to
statistics and qualitative methods, quantitative methods,
epidemiology, common research methods and outcomes, useful tests
used in epidemiological studies, research ethics, measures of
mortality and economic analyses. Each chapter features unique,
topic specific questions to reinforce comprehension, with an entire
final chapter devoted to sample questions, comprehensively testing
expertise and developing confidence. Ideal for revision and
self-examination, RCGP AKT: Research, Epidemiology and Statistics
gives GP trainees vital edge when preparing for the AKT.
Before a separate Department of Medical Humanities was formed, the
editors of this volume were faculty members of the Department of
Pediatrics at our medical school. Colleagues daily spoke of the
moral and social problems of children's health care. Our offices
were near the examining rooms where children had their bone-marrow
procedures done. Since this is a painful test, we often heard them
cry. The hospital floor where the sickest children stayed was also
nearby. The physicians, nurses, and social workers believed that
children's health care needs were not being met and that more could
and should be done. Fewer resources are available for a child than
for an adult with a comparable illness, they said. These
experiences prompted us to prepare this volume and to ask whether
children do get their fair share of the health care dollar. Since
the question "What kind of health care do we owe to our children?"
is complex, responses should be rooted in many disciplines. These
include philosophy, law, public policy and, of course, the health
professions. Representing all of these disciplines, contributors to
this volume reflect on moral and social issues in children's health
care. The last hundred years have brought great changes in health
care tor children. The specialty of pediatrics developed during
this period, and with it, a new group of advocates for children's
health care. Women's suffrage gave a political boost to the
recognition of children's special health needs.
This book constitutes a status report on health conditions
(including nutrition and freshwater supply) in the Pacific Island
Nations. The report is based on investigations carried out over the
past decade by the Pacific Science Association and includes ethnic,
demographic, historic, economic, political, climatological and
ecological aspects. As such, it will serve as an important
decision-making tool with respect to criteria for future
development, taking into account the very special carrying
capacities of the island territories concerned.
Mental retardation in the United States is currently defined as "
... signif icantly subaverage general intellectual functioning
existing concurrently with deficits in adaptive behavior, and
manifested during the development period" (Grossman, 1977). Of the
estimated six million plus mentally retarded individuals in this
country fully 75 to 85% are considered to be "func tionally"
retarded (Edgerton, 1984). That is, they are mildly retarded
persons with no evident organic etiology or demonstrable brain
pathology. Despite the relatively recent addition of adaptive
behavior as a factor in the definition of retardation, 1.0. still
remains as the essential diagnostic criterion (Edgerton, 1984: 26).
An 1.0. below 70 indicates subaverage functioning. However, even
such an "objective" measure as 1.0. is prob lematic since a variety
of data indicate quite clearly that cultural and social factors are
at play in decisions about who is to be considered "retarded"
(Edgerton, 1968; Kamin, 1974; Langness, 1982). Thus, it has been
known for quite some time that there is a close relationship
between socio-economic status and the prevalence of mild mental
retardation: higher socio-economic groups have fewer mildly
retarded persons than lower groups (Hurley, 1969). Similarly, it is
clear that ethnic minorities in the United States - Blacks,
Mexican-Americans, American Indians, Puerto Ricans, Hawaiians, and
others - are disproportionately represented in the retarded
population (Mercer, 1968; Ramey et ai., 1978)."
The culture of contemporary medicine is the object of investigation
in this book; the meanings and values implicit in biomedical
knowledge and practice and the social processes through which they
are produced are examined through the use of specific case studies.
The essays provide examples of how various facets of 20th century
medicine, including edu cation, research, the creation of medical
knowledge, the development and application of technology, and day
to day medical practice, are per vaded by a value system
characteristic of an industrial-capitalistic view of the world in
which the idea that science represents an objective and value free
body of knowledge is dominant. The authors of the essays are
sociologists and anthropologists (in almost equal numbers); also
included are papers by a social historian and by three physicians
all of whom have steeped themselves in the social sci ences and
humanities. This co-operative endeavor, which has necessi tated the
breaking down of disciplinary barriers to some extent, is per haps
indicative of a larger movement in the social sciences, one in
which there is a searching for a middle ground between grand theory
and attempts at universal explanations on the one hand, and the
context-spe cific empiricism and relativistic accounts
characteristic of many historical and anthropological analyses on
the other."
The meaning and application of the principle of beneficence to
issues in health care is rarely clear or certain. Although the
principle is frequently employed to justify a variety of actions
and inactions, very little has been done from a conceptual point of
view to test its relevance to these behaviors or to explore its
relationship to other moral principles that also might be called
upon to guide or justify conduct. Perhaps more than any other, the
principle of benef icence seems particularly appropriate to
contexts of health care in which two or more parties interact from
positions of relative strength and weakness, advantage and need, to
pursue some perceived goal. It is among those moral principles that
Tom L. Beauchamp and James F. Childress selected in their textbook
on bioethics as applicable to biomedicine in general and relevant
to a range of specific issues ( 1], pp. 135-167). More narrowly,
The National Commission for the Protection of Human Subjects of
Biomedical and Behav ioral Research identified beneficence as among
those moral principles that have particular relevance to the
conduct of research involving humans (2). Thus, the principle of
beneficence is seen as pertinent to the routine delivery of health
care, the discovery of new therapies, and the rationale of public
policies related to health care."
A solid knowledge base and good clinical skills don't necessarily
guarantee examination success in the long case OSCE. This book is
the ultimate guide for medical students needing to combine their
knowledge and skills with an ability to interpret the clinical
findings, the proficiency to present them clearly and the
confidence to deal with the examiners questions. Adopting a proven,
highly effective approach, this revision aid uses role play with
simulated patients to hone clinical examination and presentation
skills. The fifty cases are divided into six areas: cardiology,
respiratory, abdomen, neurology, musculoskeletal and surgery.
Written by successful candidates and examiners, the guide poses a
number of important and commonly asked examination questions for
each case to assist in preparation and confidence, and model
answers are provided to ensure an understanding of exactly what is
required. Working in groups or independently, students will welcome
the large, colourful format, the breakdown of marking schemes, an
overview of examiners expectations, a guide to presenting clinical
findings and innumerable 'insider' tips throughout. See
accompanying video here:
https://www.youtube.com/watch?v=Cvr4y-NykUU
This is the first volume ever published to examine the objective
and subjective qualities of Korean life from both comparative and
dynamic perspectives. It presents non-Western policy alternatives
to enhancing the quality of citizens' lives, distinguishing Korea
as an Asian model of economic prosperity and political democracy.
The book is intended for academics, policy makers and the general
public interested in recent developments in Korea.
Master the terminology you need to communicate clearly and
confidently in the healthcare setting! Using small learning
segments or "chunks," Mastering Healthcare Terminology, 7th Edition
makes it easy to learn medical terms and definitions. Concepts and
terms are immediately followed by exercises to reinforce and assess
your understanding. Organizing terminology by body system, the book
covers prefixes, suffixes, and word roots, and realistic case
studies help you apply your knowledge to practice. Special boxes
help you avoid terminology pitfalls. Written by respected educator
Betsy Shiland, this book includes an Evolve website with medical
animations, flash cards, quizzes, word games, and more. Frequent
word part and word building exercises reinforce your understanding
with immediate opportunities for practice and review. Pathology and
diagnostic terminology tables summarize the phonetic pronunciation
of terms, word origin, and definitions. Case studies provide an
opportunity to see terminology in use. Be Careful boxes remind you
of potentially confusing look-alike or sound-alike word parts and
terms. Age Matters boxes highlight important concepts and
terminology for both pediatric and geriatric patients. Labeling
exercises and hundreds of illustrations help you learn anatomy and
the accompanying combining forms. Focus On boxes put it all
together by highlighting a disorder or procedure that uses the
medical terminology presented throughout the chapter. Coverage of
electronic medical records prepares you for using EHR in the
healthcare setting. Evolve website includes medical animations,
electronic flash cards, quizzes, and word games such as Tournament
of Terminology, Medical Millionaire, and Match the Word Part. NEW!
Point of Interest boxes offer a complete picture of selected
diseases and procedures. NEW gradable activities are added to the
Evolve website for this edition. NEW terms and photos keep you up
to date with advances in healthcare.
Examining the combined impact of technology and the increasingly
competitive market on the delivery and financing of health care,
this volume makes a significant contribution to an issue of major
importance to the American people. Health care has become a major
industry that is changing rapidly and strikingly. This contributor
volume focuses on the interplay among technology, the changing
environment of health care, and its implications for future
technological innovation. Particular focus is placed on the
hospital in light of changes in federal funding (Medicare's
prospective payment system, using diagnosis-related groups) with
its orientation towards cost efficiency and cost-reducing
technology. Academics, practitioners, and government personnel
involved in hospital management, health care, and policy will find
this volume a major resource.
This book is a collection of 18 papers by leading authorities
inspired by the 1987 Conference on Health Technology Adoption in a
DRG Age. It is divided into four sections: Technology and Health
Care Content; Technology and the Health Care Organization;
Technology and the Changing Environment; Implications for
Technology Policy
My 'discovery' of the Polish School of philosophy of medicine
stemmed from my studies in the genesis of Ludwik Fleck's
epistemology. These studies, and my interest in the scientific
roots of Fleck's epistemology were a nearly 'natural' result of my
own biography: like Fleck I had been trained, an had worked as an
immunologist, and had later switched to studies in the social
history of medicine and biology. Moreover, it so happened that
Fleck's book, Genesis and Development of a Scientific Fact -the
description of a science as it is, not as it should be -was the
first epistemological study in which I found echos of my experience
in the laboratory. My interest in Fleck was also highlightened by
the fact that in his works, and, as I discovered later, in the
works of his predecessors of the Polish School of philosophy of
medicine, was formulated the problem that had stimulated my
interest in the history of medicine and biology, and is still
central to my present investigations: the relationships between
biological knowledge and clinical practice. The writing of the book
was made possible through to the help of many colleagues and
friends. The unfailing support for my research, whatever its
subject might be, from my colleagues from Unit 158 of INSERM and in
particular from its head Patrice Pinell, has made my study of the
Polish School possible.
This study seeks to resolve differences between various types of
political leaders and to link broad historical patterns with the
idiosyncratic circumstances of individual lives and careers--to
integrate the micro and the macro levels of understanding in the
field of leadership studies. To accomplish this task, a vast array
of previous scholarship and primary documents has been assembled
and drawn into new combinations. Equivalent data on all U.S.
presidents enable an unprecedented internal comparison within this
select group. Comparison with parallel data, developed for other
types of leaders, permits U.S. presidents to be analyzed in
comparative perspective for the first time. Against this
background, the study creates a unique collection of medical and
psychological profiles for the entire set of presidents--a body of
data that allows us to discover new combinations and patterns of
presidential traits.
American presidents emerged from this study looking very much
like other political leaders in terms of social background and
preparation for a political career. But contrary to myth, the
authors found U.S. presidents to be puzzingly unexceptional--even
average--in their personal and career characteristics. For other
types of leaders, the authors had found distinctive combinations of
traits and experiences that seemed to account for their political
leadership roles. For the presidents, such combinations seemed
elusive, even confounding. They did conclude, however, that
presidential leadership is firmly anchored in the cultural,
sociological, and historical contexts from which it emerges.
The majority of countries are faced with challenges of how to
finance and effectively manage their health systems so that they
benefit all their citizens without any undue discrimination.
Developing countries are particularly worse off since their health
systems are weak in terms of health expenditures, leadership,
governance and capacity to plan and budget. This book provides an
overview of the elements of health sector reforms that countries in
Sub Sahara Africa have implemented, the rationale for the reforms,
the challenges experienced and the socio-economic environment in
which these reforms are being implemented. The significance and
implications of the evolving aid architecture and global
initiatives are discussed. This theoretical background and analysis
is completed by a detailed description of the rationale,
implementation framework, implications and outcome of heath sector
reform experiences in Zimbabwe.
Although the investigation and regulation of the faculties of the
human mind appear to be the proper and sole concern of
philosophers, you see that they are in some part nevertheless so
little foreign to the medical forum that while someone may deny
that they are proper to the physician he cannot deny that
physicians have the obliga tion to philosophize. Jerome Gaub, De
regimine mentis, IV, 10 ( 10], p. 40) The Second Trans-Disciplinary
Symposium on Philosophy and Medicine, whose principal theme was
'Philosophical Dimensions of the Neuro-Medical Sciences, ' convened
at the University of Connecticut Health Center at the invitation of
Robert U. Massey, Dean of the School of Medicine, during May 15,
16, and 17, 1975. The Proceedings constitute this volume. At this
Symposium we intended to realize sentiments which Sir John Eccles
ex pressed as director of a Study Week of the Pontificia Academia
Scientiarum, CiWl del Vaticano, in the fall of 1964: "Certainly
when one comes to a study] . . . devoted to brain and mind it is
not possible to exclude relations with philosophy" ( 5], p. viii).
During that study week in 1964, a group of distinguished biomedical
and behavioral scientists met under the director ship of Sir John
C. Eccles to relate psychology to what Sir John called 'the
Neurosciences. ' The purpose of that study week was to treat issues
con cerning the functions of the brain and, in particular, to
concentrate upon the relations between brain functions and
consciousness."
Western pharmaceuticals are flooding the Third World. Injections,
capsules and tablets are available in city markets and village
shops, from 'traditional' practitioners and street vendors, as well
as from more orthodox sources like hospitals. Although many are
aware of this 'pharmaceutical invasion', little has been written
about how local people perceive and use these products. This book
is a first attempt to remedy that situation. It presents studies of
the ways Western medicines are circulated and understood in the
cities and rural areas of Africa, Asia and Latin America. We feel
that such a collection is long overdue for two reasons. The first
is a practical one: people dealing with health problems in
developing countries need information about local situations and
they need examples of methods they can use to examine the
particular contexts in which they are working. We hope that this
book will be useful for pharmacists, doctors, nurses, health
planners, policy makers and concerned citizens, who are interested
in the realities of drug use. Why do people want various kinds of
medicine? How do they evaluate and choose them and how do they
obtain them? The second reason for these studies of medicines is to
fill a need in medical anthropology as a field of study. Here we
address our colleagues in anthropol ogy, medical sociology and
related disciplines."
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