Title: Just doctoring: medical ethics in the liberal state 
Author: Brennan, Troyen A
Published: University of California Press,  1991
Subjects: Philosophy | Ethics | Medicine
Publisher's Description: Just Doctoring draws the doctor-patient relationship out of the consulting room and into the middle of the legal and political arenas where it more and more frequently appears. Traditionally, medical ethics has focused on the isolated relationship of physician to patient in a setting that has left the physician virtually untouched by market constraints or government regulation. Arguing that changes in health care institutions and legal attention to patient rights have made conventional approaches obsolete, Troyen Brennan points the way to a new, more aware and engaged medical ethics.The medical profession is no longer isolated, even theoretically, from the liberal, market-dominated state. Old ideas of physician beneficence and altruism must make way for a justice-based medical ethics, assuming a relationship between equals more compatible with liberal political philosophy. Brennan offers clinical examples of many of today's most challenging medical problems - from informed consent to care rationing and the repercussions of the HIV epidemic - and gives his recommendation for a new ethical perspective. This lively and controversial plea for a rethinking of medical ethics goes right to the heart of medical care at the end of the twentieth century.   [brief]
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Title: Paths to Asian medical knowledge
Author: Leslie, Charles M 1923-
Published: University of California Press,  1992
Subjects: Anthropology | Medical Anthropology | Asian Studies
Publisher's Description: Like its classic predecessor, Asian Medical Systems , Paths to Asian Medical Knowledge significantly expands the study of Asian medicine. These essays ask how patients and practitioners know what they know - what evidence of disease or health they consider convincing and what cultural traditions and symbols guide their thinking. Whether discussing Japanese anatomy texts, Islamic humoralism, Ayurvedic clinical practice, or a variety of other subjects, the authors offer an exciting range of information and suggest new theoretical avenues for medical anthropology.   [brief]
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Title: Managing the medical arms race: public policy and medical device innovation 
Author: Foote, Susan Bartlett
Published: University of California Press,  1992
Subjects: Politics | Medicine | Public Policy | Economics and Business
Publisher's Description: The allure of medical innovation is powerful - it holds out the promise of perfect health, the end of pain, the deferral of death. Our insatiable appetite for costly new technologies, fed by a profusion of innovations and the profits they generate, has led to what has been dubbed the medical arms race. During the last several decades government has been called upon to manage the escalation of this race.Foote has written the first comprehensive examination of the profound influence of government policies on medical innovation. She explains how these policies have proliferated to affect every stage of the innovative process in medical device technology - from the first research idea to the patient's bedside. Drawing on case studies of technologies as diverse as lasers, cardiac pacemakers, CT scanners, and IUDs, she traces the interaction between the industry and government institutions, including the National Institutes of Health, the FDA, and the Medicare and Medicaid programs.Public policies during the 1950s and 1960s, Foote discovers, tended to promote innovation, while the regulation and cost controls of the 1970s and 1980s began to inhibit it. For the 1990s and beyond she proposes incremental policy improvements that will rationalize and streamline government intervention. She cautions that we must recognize the limits of medical technology and public policy to cure all ills.Medical innovation is a crucial part of health care reform, a subject of increasing complexity and controversy. Written clearly and accessibly, Managing the Medical Arms Race is an invaluable source for medical, industry, and policy professionals, but it also has much to say to anybody concerned with how we as a society choose to take care of our health.   [brief]
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Title: Life without disease: the pursuit of medical utopia 
Author: Schwartz, William B 1922-
Published: University of California Press,  1998
Subjects: Science | Medicine | Economics and Business | History and Philosophy of Science | Public Policy
Publisher's Description: The chaotic state of today's health care is the result of an explosion of effective medical technologies. Rising costs will continue to trouble U.S. health care in the coming decades, but new molecular strategies may eventually contain costs. As life expectancy is dramatically extended by molecular medicine, a growing population of the aged will bring new problems. In the next fifty years genetic intervention will shift the focus of medicine in the United States from repairing the ravages of disease to preventing the onset of disease. Understanding the role of genes in human health, says Dr. William B. Schwartz, is the driving force that will change the direction of medical care, and the age-old dream of life without disease may come close to realization by the middle of the next century. Medical care in 2050 will be vastly more effective, Schwartz maintains, and it may also be less expensive than the resource-intensive procedures such as coronary bypass surgery that medicine relies on today.Schwartz's alluring prospect of a medical utopia raises urgent questions, however. What are the scientific and public policy obstacles that must be overcome if such a goal is to become a reality? Restrictions on access imposed by managed care plans, the corporatization of charitable health care institutions, the increasing numbers of citizens without health insurance, the problems with malpractice insurance, and the threatened Medicare bankruptcy - all are the legacy of medicine's great progress in mastering the human body and society's inability to assimilate that mastery into existing economic, ethical, and legal structures. And if the average American life span is 130 years, a genuine possibility by 2050, what social and economic problems will result?Schwartz examines the forces that have brought us to the current health care state and shows how those same forces will exert themselves in the decades ahead. Focusing on the inextricable link between scientific progress and health policy, he encourages a careful examination of these two forces in order to determine the kind of medical utopia that awaits us. The decisions we make will affect not only our own care, but also the system of care we bequeath to our children.   [brief]
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Title: American medicine: the quest for competence
Author: Good, Mary-Jo DelVecchio
Published: University of California Press,  1995
Subjects: Medicine | Science | Medical Anthropology | Public Policy
Publisher's Description: What does it mean to be a good doctor in America today? How do such challenges as new biotechnologies, the threat of malpractice suits, and proposed health-care reform affect physicians' ability to provide quality care?These and many other crucial questions are examined in this book, the first to fully explore the meaning and politics of competence in modern American medicine. Based on Mary-Jo DelVecchio Good's recent ethnographic studies of three distinct medical communities - physicians in rural California, academics and students involved in Harvard Medical School's innovative "New Pathway" curriculum, and oncologists working on breast cancer treatment - the book demonstrates the centrality of the issue of competence throughout the medical world. Competence, it shows, provides the framework for discussing the power struggles between rural general practitioners and specialists, organizational changes in medical education, and the clinical narratives of high-technology oncologists. In their own words, practitioners, students, and academics describe what competence means to them and reveal their frustration with medical-legal institutions, malpractice, and the limitations of peer review and medical training.Timely and provocative, this study is essential reading for medical professionals, academics, anthropologists, and sociologists, as well as health-care policymakers.   [brief]
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Title: Writing at the margin: discourse between anthropology and medicine
Author: Kleinman, Arthur
Published: University of California Press,  1997
Subjects: Anthropology | Medical Anthropology | Sociology | Medicine | Asian Studies | Social Problems
Publisher's Description: One of the most influential and creative scholars in medical anthropology takes stock of his recent intellectual odysseys in this collection of essays. Arthur Kleinman, an anthropologist and psychiatrist who has studied in Taiwan, China, and North America since 1968, draws upon his bicultural, multidisciplinary background to propose alternative strategies for thinking about how, in the postmodern world, the social and medical relate. Writing at the Margin explores the border between medical and social problems, the boundary between health and social change. Kleinman studies the body as the mediator between individual and collective experience, finding that many health problems - for example the trauma of violence or depression in the course of chronic pain - are less individual medical problems than interpersonal experiences of social suffering. He argues for an ethnographic approach to moral practice in medicine, one that embraces the infrapolitical context of illness, the responses to it, the social institutions relating to it, and the way it is configured in medical ethics.Previously published in various journals, these essays have been revised, updated, and brought together with an introduction, an essay on violence and the politics of post-traumatic stress disorder, and a new chapter that examines the contemporary ethnographic literature of medical anthropology.   [brief]
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Title: What I learned in medical school: personal stories of young doctors
Author: Takakuwa, Kevin M
Published: University of California Press,  2004
Subjects: Medicine | Sociology | Ethnic Studies | Gender Studies | Anthropology | Health Care
Publisher's Description: Like many an exclusive club, the medical profession subjects its prospective members to rigorous indoctrination: medical students are overloaded with work, deprived of sleep and normal human contact, drilled and tested and scheduled down to the last minute. Difficult as the regimen may be, for those who don't fit the traditional mold - white, male, middle-to-upper class, and heterosexual - medical school can be that much more harrowing. This riveting book tells the tales of a new generation of medical students - students whose varied backgrounds are far from traditional. Their stories will forever alter the way we see tomorrow's doctors. In these pages, a black teenage mother overcomes seemingly insurmountable odds, an observant Muslim dons the hijab during training, an alcoholic hides her addiction. We hear the stories of an Asian refugee, a Mexican immigrant, a closeted Christian, an oversized woman - these once unlikely students are among those who describe their medical school experiences with uncommon candor, giving a close-up look at the inflexible curriculum, the pervasive competitive culture, and the daunting obstacles that come with being "different" in medical school. Their tales of courage are by turns poignant, amusing, eye-opening - and altogether unforgettable.   [brief]
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Title: Colonizing the body: state medicine and epidemic disease in nineteenth-century India
Author: Arnold, David 1946-
Published: University of California Press,  1993
Subjects: Asian Studies | South Asia | Asian History | Medicine | History
Publisher's Description: In this innovative analysis of medicine and disease in colonial India, David Arnold explores the vital role of the state in medical and public health activities, arguing that Western medicine became a critical battleground between the colonized and the colonizers.Focusing on three major epidemic diseases - smallpox, cholera, and plague - Arnold analyzes the impact of medical interventionism. He demonstrates that Western medicine as practiced in India was not simply transferred from West to East, but was also fashioned in response to local needs and Indian conditions.By emphasizing this colonial dimension of medicine, Arnold highlights the centrality of the body to political authority in British India and shows how medicine both influenced and articulated the intrinsic contradictions of colonial rule.   [brief]
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Title: Under the medical gaze: facts and fictions of chronic pain
Author: Greenhalgh, Susan
Published: University of California Press,  2001
Subjects: Anthropology | Folklore and Mythology | Medical Anthropology | Physical Anthropology | Cultural Anthropology | Medicine | Gender Studies | Sociology | Social Problems | Social Problems
Publisher's Description: This compelling account of the author's experience with a chronic pain disorder and subsequent interaction with the American health care system goes to the heart of the workings of power and culture in the biomedical domain. It is a medical whodunit full of mysterious misdiagnosis, subtle power plays, and shrewd detective work. Setting a new standard for the practice of autoethnography, Susan Greenhalgh presents a case study of her intense encounter with an enthusiastic young specialist who, through creative interpretation of the diagnostic criteria for a newly emerging chronic disease, became convinced she had a painful, essentially untreatable, lifelong muscle condition called fibromyalgia. Greenhalgh traces the ruinous effects of this diagnosis on her inner world, bodily health, and overall well-being. Under the Medical Gaze serves as a powerful illustration of medicine's power to create and inflict suffering, to define disease and the self, and to manage relationships and lives. Greenhalgh ultimately learns that she had been misdiagnosed and begins the long process of undoing the physical and emotional damage brought about by her nearly catastrophic treatment. In considering how things could go so awry, she embarks on a cogent and powerful analysis of the sociopolitical sources of pain through feminist, cultural, and political understandings of the nature of medical discourse and practice in the United States. She develops fresh arguments about the power of medicine to medicalize our selves and lives, the seductions of medical science, and the deep, psychologically rooted difficulties women patients face in interactions with male physicians. In the end, Under the Medical Gaze goes beyond the critique of biomedicine to probe the social roots of chronic pain and therapeutic alternatives that rely on neither the body-cure of conventional medicine nor the mind-cure of some alternative medicines, but rather a broader set of strategies that address the sociopolitical sources of pain.   [brief]
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Title: A flourishing Yin: gender in China's medical history, 960-1665
Author: Furth, Charlotte
Published: University of California Press,  1999
Subjects: History | Asian History | Asian Studies | Women's Studies | China | Medicine
Publisher's Description: This book brings the study of gender to Chinese medicine and in so doing contextualizes Chinese medicine in history. It examines the rich but neglected tradition of fuke , or medicine for women, over the seven hundred years between the Song and the end of the Ming dynasty. Using medical classics, popular handbooks, case histories, and belles lettres , it explores evolving understandings of fertility and menstruation, gestation and childbirth, sexuality, and gynecological disorders.Furth locates medical practice in the home, where knowledge was not the monopoly of the learned physician and male doctors had to negotiate the class and gender boundaries of everyday life. Women as healers and as patients both participated in the dominant medical culture and sheltered a female sphere of expertise centered on, but not limited to, gestation and birth. Ultimately, her analysis of the relationship of language, text, and practice reaches beyond her immediate subject to address theoretical problems that arise when we look at the epistemological foundations of our knowledge of the body and its history.   [brief]
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Title: The making of rehabilitation: a political economy of medical specialization, 1890-1980
Author: Gritzer, Glenn
Published: University of California Press,  1989
Subjects: Anthropology | Cultural Anthropology
Publisher's Description: Focusing on the history of one medical field - rehabilitation medicine - this book provides the first systematic analysis of the underlying forces that shape medical specialization, challenging traditional explanations of occupational specialization.
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Title: Healing the masses: Cuban health politics at home and abroad
Author: Feinsilver, Julie Margot
Published: University of California Press,  1993
Subjects: Latin American Studies | Politics | Medicine | Public Policy
Publisher's Description: How has Cuba, a small, developing country, achieved its stunning medical breakthroughs? Hampered by scarce resources and a long-standing U.S. embargo, Cuba nevertheless has managed to provide universal access to health care, comprehensive health education, and advanced technology, even amid desperate economic conditions. Moreover, Cuba has sent disaster relief, donations of medical supplies and technology, and cadres of volunteer doctors throughout the world, emerging, in Castro's phrase, as a "world medical power."In her significant and timely study, Julie Feinsilver explores the Cuban medical phenomenon, examining how a governmental obsession with health has reaped medical and political benefits at home and abroad. As a result of Cuba's forward strides in health care, infant mortality rates are low even by First World standards. Cuba has successfully dealt with the AIDS epidemic in a manner that has aroused controversy and that some claim has infringed on individual liberties - issues that Feinsilver succinctly evaluates.Feinsilver's research and travel in Cuba over many years give her a unique perspective on the challenges Cuba faces in this time of unprecedented economic and political uncertainty. Her book is a must-read for everyone concerned with health policy, international relations, and Third World societies.   [brief]
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Title: Whitman and the romance of medicine
Author: Davis, Robert Leigh 1956-
Published: University of California Press,  1997
Subjects: American Studies | American Literature | Gender Studies
Publisher's Description: In this compelling, accessible examination of one of America's greatest cultural and literary figures, Robert Leigh Davis details the literary and social significance of Walt Whitman's career as a nurse during the American Civil War. Davis shows how the concept of "convalescence" in nineteenth-century medicine and philosophy - along with Whitman's personal war experiences - provide a crucial point of convergence for Whitman's work as a gay and democratic writer.In his analysis of Whitman's writings during this period - Drum-Taps, Democratic Vistas, Memoranda During the War , along with journalistic works and correspondence - Davis argues against the standard interpretation that Whitman's earliest work was his best. He finds instead that Whitman's hospital writings are his most persuasive account of the democratic experience. Deeply moved by the courage and dignity of common soldiers, Whitman came to identify the Civil War hospitals with the very essence of American democratic life, and his writing during this period includes some of his most urgent reflections on suffering, sympathy, violence, and love. Davis concludes this study with an essay on the contemporary medical writer Richard Selzer, who develops the implications of Whitman's ideas into a new theory of medical narrative.   [brief]
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Title: Ancient Titicaca: the evolution of complex society in southern Peru and northern Bolivia
Author: Stanish, Charles 1956-
Published: University of California Press,  2003
Subjects: Anthropology | Cultural Anthropology | Archaeology | Latin American Studies
Publisher's Description: One of the richest and most complex civilizations in ancient America evolved around Lake Titicaca in southern Peru and northern Bolivia. This book is the first comprehensive synthesis of four thousand years of prehistory for the entire Titicaca region. It is a fascinating story of the transition from hunting and gathering to early agriculture, to the formation of the Tiwanaku and Pucara civilizations, and to the double conquest of the region, first by the powerful neighboring Inca in the fifteenth century and a century later by the Spanish Crown. Based on more than fifteen years of field research in Peru and Bolivia, Charles Stanish's book brings together a wide range of ethnographic, historical, and archaeological data, including material that has not yet been published. This landmark work brings the author's intimate knowledge of the ethnography and archaeology in this region to bear on major theoretical concerns in evolutionary anthropology. Stanish provides a broad comparative framework for evaluating how these complex societies developed. After giving an overview of the region's archaeology and cultural history, he discusses the history of archaeological research in the Titicaca Basin, as well as its geography, ecology, and ethnography. He then synthesizes the data from six archaeological periods in the Titicaca Basin within an evolutionary anthropological framework. Titicaca Basin prehistory has long been viewed through the lens of first Inca intellectuals and the Spanish state. This book demonstrates that the ancestors of the Aymara people of the Titicaca Basin rivaled the Incas in wealth, sophistication, and cultural genius. The provocative data and interpretations of this book will also make us think anew about the rise and fall of other civilizations throughout history.   [brief]
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Title: The corporate practice of medicine: competition and innovation in health care
Author: Robinson, James C 1953-
Published: University of California Press,  1999
Subjects: Politics | Public Policy | Medicine | Economics and Business
Publisher's Description: One of the country's leading health economists presents a provocative analysis of the transformation of American medicine from a system of professional dominance to an industry under corporate control. James Robinson examines the economic and political forces that have eroded the traditional medical system of solo practice and fee-for-service insurance, hindered governmental regulation, and invited the market competition and organizational innovations that now are under way. The trend toward health care corporatization is irreversible, he says, and it parallels analogous trends toward privatization in the world economy.The physician is the key figure in health care, and how physicians are organized is central to the health care system, says Robinson. He focuses on four forms of physician organization to illustrate how external pressures have led to health care innovations: multispecialty medical groups, Independent Practice Associations (IPAs), physician practice management firms, and physician-hospital organizations. These physician organizations have evolved in the past two decades by adopting from the larger corporate sector similar forms of ownership, governance, finance, compensation, and marketing.In applying economic principles to the maelstrom of health care, Robinson highlights the similarities between competition and consolidation in medicine and in other sectors of the economy. He points to hidden costs in fee-for-service medicine - overtreatment, rampant inflation, uncritical professional dominance regarding treatment decisions - factors often overlooked when newer organizational models are criticized.Not everyone will share Robinson's appreciation for market competition and corporate organization in American health care, but he challenges those who would return to the inefficient and inequitable era of medicine from which we've just emerged. Forcefully written and thoroughly documented, The Corporate Practice of Medicine presents a thoughtful - and optimistic - view of a future health care system, one in which physician entrepreneurship is a dynamic component.   [brief]
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Title: Huang Di nei jing su wen: nature, knowledge, imagery in an ancient Chinese medical text, with an appendix, The doctrine of the five periods and six qi in the Huang Di nei jing su wen
Author: Unschuld, Paul U. (Paul Ulrich) 1943-
Published: University of California Press,  2003
Subjects: Anthropology | Asian Studies | Medical Anthropology | China | History of Medicine
Publisher's Description: The Huang Di nei jing su wen, known familiarly as the Su wen, is a seminal text of ancient Chinese medicine, yet until now there has been no comprehensive, detailed analysis of its development and contents. At last Paul U. Unschuld offers entry into this still-vital artifact of China's cultural and intellectual past. Unschuld traces the history of the Su wen to its origins in the final centuries B.C.E., when numerous authors wrote short medical essays to explain the foundations of human health and illness on the basis of the newly developed vessel theory. He examines the meaning of the title and the way the work has been received throughout Chinese medical history, both before and after the eleventh century when the text as it is known today emerged. Unschuld's survey of the contents includes illuminating discussions of the yin-yang and five-agents doctrines, the perception of the human body and its organs, qi and blood, pathogenic agents, concepts of disease and diagnosis, and a variety of therapies, including the new technique of acupuncture. An extensive appendix, furthermore, offers a detailed introduction to the complicated climatological theories of Wu yun liu qi ("five periods and six qi"), which were added to the Su wen by Wang Bing in the Tang era. In an epilogue, Unschuld writes about the break with tradition and innovative style of thought represented by the Su wen. For the first time, health care took the form of "medicine," in that it focused on environmental conditions, climatic agents, and behavior as causal in the emergence of disease and on the importance of natural laws in explaining illness. Unschuld points out that much of what we surmise about the human organism is simply a projection, reflecting dominant values and social goals, and he constructs a hypothesis to explain the formation and acceptance of basic notions of health and disease in a given society. Reading the Su wen, he says, not only offers a better understanding of the roots of Chinese medicine as an integrated aspect of Chinese civilization; it also provides a much needed starting point for discussions of the differences and parallels between European and Chinese ways of dealing with illness and the risk of early death.   [brief]
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Title: Taming the wind of desire: psychology, medicine, and aesthetics in Malay shamanistic performance
Author: Laderman, Carol
Published: University of California Press,  1991
Subjects: Anthropology | Asian Studies | Medical Anthropology | Psychology | Southeast Asia | Medicine
Publisher's Description: Charged with restoring harmony and relieving pain, the Malay shaman places his patients in trance and encourages them to express their talents, drives, personality traits - the "Inner Winds" of Malay medical lore - in a kind of performance. These healing ceremonies, formerly viewed by Western anthropologists as exotic curiosities, actually reveal complex multicultural origins and a unique indigenous medical tradition whose psychological content is remarkably relevant to contemporary Western concerns.Accepted as apprentice to a Malay shaman, Carol Laderman learned and recorded every aspect of the healing seance and found it comparable in many ways to the traditional dramas of Southeast Asia and of other cultures such as ancient Greece, Japan, and India. The Malay seance is a total performance, complete with audience, stage, props, plot, music, and dance. The players include the patient along with the shaman and his troupe. At the center of the drama are pivotal relationships - among people, between humans and spirits, and within the self. The best of the Malay shamans are superb poets, dramatists, and performers as well as effective healers of body and soul.   [brief]
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Title: Susto, a folk illness
Author: Rubel, Arthur J
Published: University of California Press,  1984
Subjects: Anthropology | Medical Anthropology | Latin American Studies | Psychology
Publisher's Description: Widespread throughout Latin America, susto is a folk illness associated with a broad array of symptoms. It is considered by susceptible populations to be a sickness caused by the separation of soul and body which is precipitated by a supernatural force. Most studies of culture-bound diseases have relied on descriptive approaches that focus on pathologies derived from medical textbooks. This study takes an interdisciplinary approach, looking for explanations of susto in the interaction of social, physiological, and psychological factors.   [brief]
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Title: Essential subtleties on the silver sea: the Yin-hai jing-wei: a Chinese classic on ophthalmology
Author: Sun, Simiao 581-682
Published: University of California Press,  1999
Subjects: Anthropology | Medical Anthropology | China | History and Philosophy of Science
Publisher's Description: Here is the first translation into English of the complete Yin-Hai Jing-Wei , a classic fifteenth-century text on Chinese ophthalmology. As one of the few original manuscripts on traditional Chinese medicine translated into a Western language, this work offers an unprecedented view of the practice of medicine, and specifically eye care, in premodern China. Superbly rendered from the classical Chinese and extensively annotated by Paul U. Unschuld and Jürgen Kovacs, the text provides detailed descriptions of the etiology, symptomatology, and therapy of every eye disease known to fifteenth-century Chinese practitioners. The translators' introduction also provides the first in-depth analysis of the development of this specialty within Chinese medicine. As a source for comparative studies of Chinese and Western medicine and numerous other issues in the history of medicine and Chinese thought, the Yin-Hai Jing-Wei has no equal in the Western world.   [brief]
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Title: Evolution of sickness and healing 
Author: Fabrega, Horacio
Published: University of California Press,  1997
Subjects: Medicine | Medical Anthropology
Publisher's Description: Evolution of Sickness and Healing is a theoretical work on the grand scale, an original synthesis of many disciplines in social studies of medicine. Looking at human sickness and healing through the lens of evolutionary theory, Horacio Fàbrega, Jr. presents not only the vulnerability to disease and injury but also the need to show and communicate sickness and to seek and provide healing as innate biological traits grounded in evolution. This linking of sickness and healing, as inseparable facets of a unique human adaptation developed during the evolution of the hominid line, offers a new vantage point from which to examine the institution of medicine.To show how this complex, integrated adaptation for sickness and healing lies at the root of medicine, and how it is expressed culturally in relation to the changing historical contingencies of human societies, Fàbrega traces the characteristics of sickness and healing through the early and later stages of social evolution. Besides offering a new conceptual structure and a methodology for analyzing medicine in evolutionary terms, he shows the relevance of this approach and its implications for the social sciences and for medical policy. Health scientists and medical practitioners, along with medical historians, economists, anthropologists, and sociologists, now have the opportunity to consider every essential aspect of medicine within an integrated framework.   [brief]
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