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.

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."

As our modem society is so obviously influenced by technology, there is a growing awareness of its importance for education. The interest for including technology as a part of general education curricula is increasing. In many countries technology is an element in the curriculum either as a topic, a project, part of a Science-Technology-Society (STS) programme, part of science education, or as a separate subject. In order to clarify what technology is, there is a need for international discussions in which philosophers, engineers, scientists and educational ists are involved. One of the few conferences with such a broad representation was the second Jerusalem International Science and Technology Education Conference (JISTEC) that was held in Jerusalem, January 8-11, 1996, a conference that can truly be seen as a milestone in the international history of technology education. More than 1,000 technology educators from more than 80 countries of the world and ministers of education from 28 coun tries came together to discuss current issues in technology education during JlSTEC. To cite from Dr. Michael Dyrenfurth's personal overview of the conference in the Journal of Industrial Teacher Education (vol. 33, no. 2, Winter 1996, pp. 83-85): 'Simply put, this conference represented the most stellar international collection of technology education advocates the world has ever seen in one place'. Or in the words of Dr."

On May 13-15, 1982, some 50 scientists and scholars - physicians, philos ophers and social scientists - convened at Hasselby Castle in Stockholm for the first Nordic Symposium on the Philosophy of Medicine. The topics for the symposium included (1) the concepts of health and disease, (2) classification in medicine, and (3) causality and causal explanations in medicine. The majority of the participants were Scandinavian but the symposium was also able to welcome four distinguished guests from other parts of the world, Professors Stuart F. Spicker and H. Tristram Engelhardt, Jr., U.S.A., Dr Anne M. Fagot, France, and Dr Werner Morbach, West Germany. The latter represented Professor Kazem Sadegh-zadeh, who unfortunately was prevented from attending. One of the main purposes of this symposium was to bring together people in Scandinavia who at present work within the field of Philosophy of Medi cine. This group is still relatively small but is growing rapidly, and the scholarly activity has recently been notable. This fact is clearly demonstrated by the presentation of 'Philosophy of Medicine in Scandinavia' in the Appendix of this volume."

In the last few years there has been a great revival of interest in culture-bound psychiatric syndromes. A spate of new papers has been published on well known and less familiar syndromes, and there have been a number of attempts to put some order into the field of inquiry. In a review of the literature on culture-bound syndromes up to 1969 Yap made certain suggestions for organizing thinking about them which for the most part have not received general acceptance (see Carr, this volume, p. 199). Through the seventies new descriptive and conceptual work was scarce, but in the last few years books and papers discussing the field were authored or edited by Tseng and McDermott (1981), AI-Issa (1982), Friedman and Faguet (1982) and Murphy (1982). In 1983 Favazza summarized his understanding of the state of current thinking for the fourth edition of the Comprehensive Textbook of Psychiatry, and a symposium on culture-bound syndromes was organized by Kenny for the Eighth International Congress of Anthropology and Ethnology. The strong est impression to emerge from all this recent work is that there is no substantive consensus, and that the very concept, "culture-bound syndrome" could well use some serious reconsideration. As the role of culture-specific beliefs and prac tices in all affliction has come to be increasingly recognized it has become less and less clear what sets the culture-bound syndromes apart."

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From the tone of the report by the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Re search, one might conclude that the whole-brain-oriented definition of death is now firmly established as an enduring element of public policy. In that report, Defining Death: Medical, Legal and Ethical Issues in the Determination of Death, the President's Commission forwarded a uni form determination of death act, which laid heavy accent on the signifi cance of the brain stem in determining whether an individual is alive or dead: An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead. A determination of death must be made in accordance with accepted medical standards ( 1], p. 2). The plausibility of these criteria is undermined as soon as one confronts the question of the level of treatment that ought to be provided to human bodies that have permanently lost consciousness but whose brain stems are still functioning."