1 Historical Introduction INTRODUCTION This chapter is mainly about the history of medicine and its ethics. As usually c- ceived, history is retrograde: It is what happened yesterday, and, much as we may try, it is what happened yesterday seen with a set of today's eyes. Trying to understand yesterday's culture may help us put on a pair of corrective glasses, but it fails in - tirely correcting our vision. Contemporary cultural anthropology may likewise help us understand the way today's events and cultural habits shape what we call history tomorrow. Past events and the kaleidoscopic pattern of today's cultures may help guide us into a future that in at least some respects is ours to forge. Learning about ethics yesterday and thinking about ethics as it expresses itself in various cultures today can help us shape the ethics of tomorrow: This is true whether we are speaking of that part of social ethics called "medical" or of any other part of social ethics. The social aspects of medical practice-how the institution called medicine fits into and works within the greater society called culture-shape the way its ethics ultimately must play itself out.

Today we have more control over how we live and how we die than we ever had before. This fact has produced many ethical problems. While much about life is biologically determined, much else is determined by the social circumstances surrounding it. Unfortunately, little energy is spent dealing with the social and psychological factors within which the medical/biological factors are imbedded. In this volume the authors examine some of the medical social and psychological conditions which affect the way we die.
Important topics covered include attitudes toward death; suicide, assisted suicide and euthanasia; hospice and pain management. This volume will be of interest to all who work with terminally ill patients.

This volume is the result of a conference sponsored by the Medical Alumni Association of the University of California, Davis and held in Sacramento, California, in January, 2000, The purpose of this conference was to examine the impact ofvarious health care structures on the ability of health care professionals to practice in an ethically acceptable manner. One of the ground assumptions made is that ethical practice in medicine and its related fields is difficult in a setting that pays only lip service to ethical principles. The limits of ethical possibility are created by the system within which health care professionals must practice. When, for example, ethical practice necessitates-as it generally does-that health care professionals spend sufficient time to come to know and understand their patients' goals and values but the system mandates that only a short time be spent with each patient, ethical practice is made virtually impossible. One of our chief frustrations in teaching health care ethics at medical colleges is that we essentially teach students to do something they are most likely to find impossible to do: that is, get to know and appreciate their patients' goals and values. There are other ways in which systems alter ethical possibilities. In a system in which patients have a different physician outside the hospital than they will inside, ethical problems have a different shape than if the treating physician is the same person.

Here, Erich H. Loewy expands on his earlier book Textbook of Medical Ethics (1989) offering healthcare workers and students a new perspective on ethical practice. Textbook of Healthcare Ethics focuses on the social conditions in which medical practice occurs and how ethical healthcare decisions involves nurses, social workers, psychologists, technicians, and patients as well as physicians. This thoroughly revised and expanded edition addresses historical and theoretical underpinnings and practical concerns. A series of case studies serve as a guideline for further discussion. The text examines provocative issues such as organ donation, care of the terminally ill, abortion, HIV-positive healthcare professionals, physician-assisted suicide, and experimentation with fetal tissue. This is an ideal book for all members of the healthcare team as well as students and residents in any discipline of medicine.

This text examines the dominant ways of looking at patient/clinician relationships in healthcare. By challenging these dominant views the author can explore presuppositions that are defective. She further explains how they come to be so readily and uncritically held and reinforced; and, why their implications can have such a profound affect on how we think and act. Using the methodology of philosopher, John Dewey, the author proposes an alternative bio/psycho/social approach to understanding the patient/clinician relationship and for resolving increasingly common bioethical issues that arise in healthcare settings.

In this volume the authors examine some of the medical social and psychological conditions which affect the way we die. Important topics covered include attitudes toward death; suicide, assisted suicide and euthanasia; hospice and pain management. This volume will be of interest to all who work with terminally ill patients.

1 Historical Introduction INTRODUCTION This chapter is mainly about the history of medicine and its ethics. As usually c- ceived, history is retrograde: It is what happened yesterday, and, much as we may try, it is what happened yesterday seen with a set of today's eyes. Trying to understand yesterday's culture may help us put on a pair of corrective glasses, but it fails in - tirely correcting our vision. Contemporary cultural anthropology may likewise help us understand the way today's events and cultural habits shape what we call history tomorrow. Past events and the kaleidoscopic pattern of today's cultures may help guide us into a future that in at least some respects is ours to forge. Learning about ethics yesterday and thinking about ethics as it expresses itself in various cultures today can help us shape the ethics of tomorrow: This is true whether we are speaking of that part of social ethics called "medical" or of any other part of social ethics. The social aspects of medical practice-how the institution called medicine fits into and works within the greater society called culture-shape the way its ethics ultimately must play itself out.

This volume is the result of a conference sponsored by the Medical Alumni Association of the University of California, Davis and held in Sacramento, California, in January, 2000, The purpose of this conference was to examine the impact ofvarious health care structures on the ability of health care professionals to practice in an ethically acceptable manner. One of the ground assumptions made is that ethical practice in medicine and its related fields is difficult in a setting that pays only lip service to ethical principles. The limits of ethical possibility are created by the system within which health care professionals must practice. When, for example, ethical practice necessitates-as it generally does-that health care professionals spend sufficient time to come to know and understand their patients' goals and values but the system mandates that only a short time be spent with each patient, ethical practice is made virtually impossible. One of our chief frustrations in teaching health care ethics at medical colleges is that we essentially teach students to do something they are most likely to find impossible to do: that is, get to know and appreciate their patients' goals and values. There are other ways in which systems alter ethical possibilities. In a system in which patients have a different physician outside the hospital than they will inside, ethical problems have a different shape than if the treating physician is the same person.