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Most of us want and expect medicine's miracles to extend our lives.
In today's aging society, however, the line between life-giving
therapies and too much treatment is hard to see-it's being obscured
by a perfect storm created by the pharmaceutical and biomedical
industries, along with insurance companies. In Ordinary Medicine
Sharon R. Kaufman investigates what drives that storm's "more is
better" approach to medicine: a nearly invisible chain of social,
economic, and bureaucratic forces that has made once-extraordinary
treatments seem ordinary, necessary, and desirable. Since 2002
Kaufman has listened to hundreds of older patients, their
physicians and family members express their hopes, fears, and
reasoning as they faced the line between enough and too much
intervention. Their stories anchor Ordinary Medicine. Today's
medicine, Kaufman contends, shapes nearly every American's
experience of growing older, and ultimately medicine is undermining
its own ability to function as a social good. Kaufman's careful
mapping of the sources of our health care dilemmas should make it
far easier to rethink and renew medicine's goals.
Most of us want and expect medicine's miracles to extend our lives.
In today's aging society, however, the line between life-giving
therapies and too much treatment is hard to see-it's being obscured
by a perfect storm created by the pharmaceutical and biomedical
industries, along with insurance companies. In Ordinary Medicine
Sharon R. Kaufman investigates what drives that storm's "more is
better" approach to medicine: a nearly invisible chain of social,
economic, and bureaucratic forces that has made once-extraordinary
treatments seem ordinary, necessary, and desirable. Since 2002
Kaufman has listened to hundreds of older patients, their
physicians and family members express their hopes, fears, and
reasoning as they faced the line between enough and too much
intervention. Their stories anchor Ordinary Medicine. Today's
medicine, Kaufman contends, shapes nearly every American's
experience of growing older, and ultimately medicine is undermining
its own ability to function as a social good. Kaufman's careful
mapping of the sources of our health care dilemmas should make it
far easier to rethink and renew medicine's goals.
There are many important questions raised in this book. The
fragmentation of medical values, whether a good doctor requires as
much knowledge of the person as of the disease, the claims created
by a scientific medicine dependent upon the largesse of government
grants, the conversion of medicine from ""cottage industry"" to
entrepreneurial endeavour, all had their beginnings in medicine's
Golden Age. Their heirs, today's practitioners, may have mistaken
technology for their task, science for their religion, and business
for their creed, but if the spirit of the physicians in this book
wins out, medicine's Golden Age is yet in the future.
Over the past thirty years, the way Americans experience death has
been dramatically altered. The advent of medical technology capable
of sustaining life without restoring health has changed where,
when, and how we die. In this revelatory study, medical
anthropologist Sharon R. Kaufman examines the powerful center of
those changes: the hospital, where most Americans die today. She
deftly links the experiences of patients and families, the work of
hospital staff, and the ramifications of institutional bureaucracy
to show the invisible power of the hospital system in shaping death
and our individual experience of it. In doing so, Kaufman also
speaks to the ways we understand what it means to be human and to
be alive.
"An act of courage and a public service."--"San Francisco Chronicle
""This beautifully synthesized and disquieting account of how
hospital patients die melds disciplined description with acute
analysis, incorporating the voices of doctors, nurses, social
workers, and patients in a provocative analysis of the modern
American quest for a 'good death.'"--"Publishers Weekly
""Kaufman exposes the bureaucratic and ethical quandaries that
hover over the modern deathbed."--"Psychology Today
""Kaufman's analysis illuminates the complexity of the care of
critically ill and dying patients and] the ambiguity of slogans
such as 'death with dignity, ' 'quality of life, ' and 'stopping
life support.' . . . Thought-provoking reading for everyone
contemplating the fate of us all."--"New England"" Journal of
Medicine
"
Among the many studies of aging and the aged, there is
comparatively little material in which the aged speak for
themselves. In this compelling study, Sharon Kaufman encourages
just such expression, recording and presenting the voices of a
number of old Americans. Her informants tell their life stories and
relate their most personal feelings about becoming old. Each story
is unique, and yet, presented together, they inevitable weave a
clear pattern, one that clashes sharply with much current
gerontological thought. With this book, Sharon Kaufman allows us to
understand the experience of the aging by listening to the aged
themselves. Kaufman, while maintaining objectivity, is able to draw
an intimate portrait of her subjects. We come to know these people
as individuals and we become involved with their lives. Through
their words, we find that the aging process is not merely a period
of sensory, functional, economic, and social decline. Old people
continue to participate in society, and-more important-continue to
interpret their participation in the social world. Through themes
constructed from these stories, we can see how the old not only
cope with losses, but how they create new meaning as they
reformulate and build viable selves. Creating identity, Kaufman
stresses, is a lifelong process. Sharon Kaufman's book will be of
interest and value not only to students of gerontology and life
span development, and to professionals in the field of aging, but
to everyone who is concerned with the aging process itself. As
Sharon Kaufman says, "If we can find the sources of meaning held by
the elderly and see how individuals put it all together, we will go
a long way toward appreciating the complexity of human aging and
the ultimate reality of coming to terms with one's whole life.
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