Title: AIDS: the making of a chronic disease 
Author: Fee, Elizabeth
Published: University of California Press,  1991
Subjects: History | Medicine | United States History | Sociology
Publisher's Description: When AIDS was first recognized in 1981, most experts believed that it was a plague, a virulent unexpected disease. They thought AIDS, as a plague, would resemble the great epidemics of the past: it would be devastating but would soon subside, perhaps never to return. By the middle 1980s, however, it became increasingly clear that AIDS was a chronic infection, not a classic plague.In this follow-up to AIDS: The Burdens of History , editors Elizabeth Fee and Daniel M. Fox present essays that describe how AIDS has come to be regarded as a chronic disease. Representing diverse fields and professions, the twenty-three contributors to this work use historical methods to analyze politics and public policy, human rights issues, and the changing populations with HIV infection. They examine the federal government's testing of drugs for cancer and HIV, and show how the policy makers' choice of a specific historical model (chronic disease versus plague) affected their decisions. A powerful photo essay reveals the strengths of women from various backgrounds and lifestyles who are coping with HIV. A sensitive account of the complex relationships of the gay community to AIDS is included. Finally, several contributors provide a sampling of international perspectives on the impact of AIDS in other nations.   [brief]
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Title: Impure science: AIDS, activism, and the politics of knowledge 
Author: Epstein, Steven
Published: University of California Press,  1996
Subjects: Social Science | Medicine | Public Policy | History and Philosophy of Science | Sociology
Publisher's Description: In the short, turbulent history of AIDS research and treatment, the boundaries between scientist insiders and lay outsiders have been crisscrossed to a degree never before seen in medical history. Steven Epstein's astute and readable investigation focuses on the critical question of "how certainty is constructed or deconstructed," leading us through the views of medical researchers, activists, policy makers, and others to discover how knowledge about AIDS emerges out of what he calls "credibility struggles."Epstein shows the extent to which AIDS research has been a social and political phenomenon and how the AIDS movement has transformed biomedical research practices through its capacity to garner credibility by novel strategies. Epstein finds that nonscientist AIDS activists have gained enough of a voice in the scientific world to shape NIH?sponsored research to a remarkable extent. Because of the blurring of roles and responsibilities, the production of biomedical knowledge about AIDS does not, he says, follow the pathways common to science; indeed, AIDS research can only be understood as a field that is unusually broad, public, and contested. He concludes by analyzing recent moves to democratize biomedicine, arguing that although AIDS activists have set the stage for new challenges to scientific authority, all social movements that seek to democratize expertise face unusual difficulties.Avoiding polemics and accusations, Epstein provides a benchmark account of the AIDS epidemic to date, one that will be as useful to activists, policy makers, and general readers as to sociologists, physicians, and scientists.   [brief]
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Title: Power and illness: the failure and future of American health policy 
Author: Fox, Daniel M
Published: University of California Press,  1993
Subjects: Sociology | Medicine | History | American Studies | United States History
Publisher's Description: During most of this century, American health policy has emphasized caring for acute conditions rather than preventing and managing chronic illness - even though chronic illness has caused most sickness and death since the 1920s. In this provocative and wide-ranging book, Daniel Fox explains why this has been so and offers a forceful argument for fundamental change in national health care priorities.Fox discusses how ideas about illness and health care, as well as the power of special interest groups, have shaped the ways in which Americans have treated illness. Those who make health policy decisions have increased support for hospitals, physicians, and medical research, believing that people then would become healthier. This position, implemented at considerable cost, has not adequately taken into account the growing burden of chronic disabling illness. While decision makers may have defined chronic disease as a high priority in research, they have not given it such a priority in the financing of health services.The increasing burden of chronic illness is critical. Fox suggests ways to solve this problem without increasing the already high cost of health care - but he does not underestimate the difficulties in such a strategy. Advocating the redistribution of resources within hospital and medical services, he targets those that are redundant or marginally effective.There could be no more timely subject today than American health care. And Daniel Fox is uniquely able to address its problems. A historian of medicine, with knowledge of how hospitals and physicians behave and how health policy is made at government levels, he has extensively researched published and unpublished documents on health care. What he proposes could profoundly affect all Americans.   [brief]
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Title: Lost lullaby
Author: Alecson, Deborah Golden 1954-
Published: University of California Press,  1995
Subjects: American Studies | Gender Studies | Women's Studies | Medicine | Ethics | Sociology
Publisher's Description: Lost Lullaby makes one think the unthinkable: how a loving parent can pray for the death of her child. It is Deborah Alecson's story of her daughter, Andrea, who was born after a full-term, uneventful pregnancy, weighing 7 pounds 11 ounces, perfectly formed and exquisitely featured. But an inexplicable accident at birth left her with massive and irreversible brain damage. On a vitality scale of one to ten, her initial reading was one. And so begins Deborah Alecson's heart-rending struggle to come to terms with two desperately conflicting and powerful emotions: her desire to nurture and love Andrea, and her desire to do everything in her power to bring about her death.Told in a mother's voice, with a simplicity and directness that heighten the intensity of the drama that unfolds, Lost Lullaby reaffirms the human dimension of what is too often an abstract and purely theoretical discussion. During the two months that Andrea spent in the Infant Intensive Care Unit, Ms. Alecson spoke with lawyers, doctors, and ethicists in an effort to understand the legal, medical and ethical implications of her plight. She recounts those discussions and describes legal cases that have a direct bearing on her own situation. Her battle - both in coming to the agonizing decision to let her child die and in convincing the medical and legal establishments to respect that decision - will engender empathy for the plight of many families, and an awareness of the need to use medical technology with restraint. It is a must-read for everyone who cares about how we make life-and-death decisions on these new medical, legal, and moral frontiers.   [brief]
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Title: Deceit and denial: the deadly politics of industrial pollution
Author: Markowitz, Gerald E
Published: University of California Press,  2002
Subjects: Medicine | Health Care | Public Policy | United States History
Publisher's Description: Deceit and Denial details the attempts by the chemical and lead industries to deceive Americans about the dangers that their deadly products present to workers, the public, and consumers. Gerald Markowitz and David Rosner pursued evidence steadily and relentlessly, interviewed the important players, investigated untapped sources, and uncovered a bruising story of cynical and cruel disregard for health and human rights. This resulting exposé is full of startling revelations, provocative arguments, and disturbing conclusions--all based on remarkable research and information gleaned from secret industry documents. This book reveals for the first time the public relations campaign that the lead industry undertook to convince Americans to use its deadly product to paint walls, toys, furniture, and other objects in America's homes, despite a wealth of information that children were at risk for serious brain damage and death from ingesting this poison. This book highlights the immediate dangers ordinary citizens face because of the relentless failure of industrial polluters to warn, inform, and protect their workers and neighbors. It offers a historical analysis of how corporate control over scientific research has undermined the process of proving the links between toxic chemicals and disease. The authors also describe the wisdom, courage, and determination of workers and community members who continue to voice their concerns in spite of vicious opposition. Readable, pathbreaking, and revelatory, Deceit and Denial provides crucial answers to questions of dangerous environmental degradation, escalating corporate greed, and governmental disregard for its citizens' safety and health.   [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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Title: What it means to be 98% chimpanzee: apes, people, and their genes
Author: Marks, Jonathan (Jonathan M.) 1955-
Published: University of California Press,  2002
Subjects: EcologyEvolutionEnvironment | Evolution | Physical Anthropology | Sociology | Medicine | Mammalogy
Publisher's Description: The overwhelming similarity of human and ape genes is one of the best-known facts of modern genetic sciencenm. But what does this similarity mean? Does it, as many have suggested, have profound implications for understanding human nature? Well-known molecular anthropologist Jonathan Marks uses the human-versus-ape controversy as a jumping-off point for a radical reassessment of a range of provocative issues--from the role of science in society to racism, animal rights, and cloning. Full of interesting facts, fascinating personalities, and vivid examples that capture times and places, this work explains and demystifies human genetic science--showing ultimately how it has always been subject to social and political influences and teaching us how to think critically about its modern findings. Marks presents the field of molecular anthropology--a synthesis of the holistic approach of anthropology with the reductive approach of molecular genetics--as a way of improving our understanding of the science of human evolution. As he explores the intellectual terrain of this field, he lays out its broad areas of interest with issues ranging from the differences between apes and humans to the biological and behavioral variations expressed in humans as a species. Marks confronts head-on the problems of racial classification in science. He describes current theories about race and uses work in primatology, comparative anatomy, and molecular anthropology to debunk them. He also sheds new light on the controversial Great Ape Project, the Human Genome Diversity Project, and much more. This iconoclastic, witty, and extremely readable book illuminates the deep background of human variation and asks us to reconsider the role of science in modern society.   [brief]
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Title: The king's midwife: a history and mystery of Madame du Coudray 
Author: Gelbart, Nina Rattner
Published: University of California Press,  1998
Subjects: History | European History | Women's Studies | Autobiographies and Biographies | French Studies | History and Philosophy of Science | Medicine
Publisher's Description: This unorthodox biography explores the life of an extraordinary Enlightenment woman who, by sheer force of character, parlayed a skill in midwifery into a national institution. In 1759, in an effort to end infant mortality, Louis XV commissioned Madame Angélique Marguerite Le Boursier du Coudray to travel throughout France teaching the art of childbirth to illiterate peasant women. For the next thirty years, this royal emissary taught in nearly forty cities and reached an estimated ten thousand students. She wrote a textbook and invented a life-sized obstetrical mannequin for her demonstrations. She contributed significantly to France's demographic upswing after 1760.Who was the woman, both the private self and the pseudonymous public celebrity? Nina Rattner Gelbart reconstructs Madame du Coudray's astonishing mission through extensive research in the hundreds of letters by, to, and about her in provincial archives throughout France. Tracing her subject's footsteps around the country, Gelbart chronicles du Coudray's battles with finance ministers, village matrons, local administrators, and recalcitrant physicians, her rises in power and falls from grace, and her death at the height of the Reign of Terror. At a deeper level, Gelbart recaptures du Coudray's interior journey as well, by questioning and dismantling the neat paper trail that the great midwife so carefully left behind. Delightfully written, this tale of a fascinating life at the end of the French Old Regime sheds new light on the histories of medicine, gender, society, politics, and culture.   [brief]
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Title: Total confinement: madness and reason in the maximum security prison
Author: Rhodes, Lorna A. (Lorna Amarasingham)
Published: University of California Press,  2004
Subjects: American Studies | Anthropology | Cultural Anthropology | Medical Anthropology | Ethnic Studies | Gender Studies | Medicine | Politics | Sociology
Publisher's Description: In this rare firsthand account, Lorna Rhodes takes us into a hidden world that lies at the heart of the maximum security prison. Focusing on the "supermaximums" - and the mental health units that complement them - Rhodes conveys the internal contradictions of a system mandated to both punish and treat. Her often harrowing, sometimes poignant, exploration of maximum security confinement includes vivid testimony from prisoners and prison workers, describes routines and practices inside prison walls, and takes a hard look at the prison industry. More than an exposé, Total Confinement is a theoretically sophisticated meditation on what incarceration tells us about who we are as a society. Rhodes tackles difficult questions about the extreme conditions of confinement, the treatment of the mentally ill in prisons, and an ever-advancing technology of isolation and surveillance. Using her superb interview skills and powers of observation, she documents how prisoners, workers, and administrators all struggle to retain dignity and a sense of self within maximum security institutions. In settings that place in question the very humanity of those who live and work in them, Rhodes discovers complex interactions - from the violent to the tender - among prisoners and staff. Total Confinement offers an indispensable close-up of the implications of our dependence on prisons to solve long-standing problems of crime and injustice in the United States.   [brief]
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Title: Healing sounds from the Malaysian rainforest: Temiar music and medicine
Author: Roseman, Marina 1952-
Published: University of California Press,  1991
Subjects: Anthropology | Medical Anthropology | East Asia Other | Ethnomusicology | Asian Studies | Cultural Anthropology | Medicine | Musicology
Publisher's Description: Music and dance play a central role in the "healing arts" of the Senoi Temiar, a group of hunters and horticulturalists dwelling in the rainforest of peninsular Malaysia. As musicologist and anthropologist, Marina Roseman recorded and transcribed Temiar rituals, while as a member of the community she became a participant and even a patient during the course of her two-year stay. She shows how the sounds and gestures of music and dance acquire a potency that can transform thoughts, emotions, and bodies.   [brief]
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Title: Infertility around the globe: new thinking on childlessness, gender, and reproductive technologies
Author: Inhorn, Marcia Claire 1957-
Published: University of California Press,  2002
Subjects: Anthropology | Cultural Anthropology | Asian Studies | Medical Anthropology | Ethnic Studies | Gender Studies | Politics | Medicine | Sociology | Sociology
Publisher's Description: This exceptional collection of essays breaks new ground by examining the global impact of infertility as a major reproductive health issue, one that has profoundly affected the lives of countless women and men. Based on original research by seventeen internationally acclaimed social scientists, it is the first book to investigate the use of reproductive technologies in non-Western countries. Provocative and incisive, it is the most substantial work to date on the subject of infertility. With infertility as the lens through which a wide range of social issues is explored, the contributors address a far-reaching array of topics: why infertility has been neglected in population studies, how the deeply gendered nature of infertility sets the blame squarely on women's shoulders, how infertility and its treatment transform family dynamics and relationships, and the distribution of medical and marital power. The chapters present informed and sophisticated investigations into cultural perceptions of infertility in numerous countries, including China, India, the nations of sub-Saharan Africa, Vietnam, Costa Rica, Egypt, Israel, the United States, and the nations of Europe. Poised to become the quintessential reference on infertility from an international social science perspective, Infertility around the Globe makes a powerful argument that involuntary childlessness is a complex phenomenon that has far-reaching significance worldwide.   [brief]
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Title: The elusive embryo: how women and men approach new reproductive technologies
Author: Becker, Gaylene
Published: University of California Press,  2000
Subjects: Anthropology | Cultural Anthropology | Sociology | Gender Studies | Medical Anthropology | Medicine | Women's Studies | Science
Publisher's Description: In the first book to examine the industry of reproductive technology from the perspective of the consumer, Gay Becker scrutinizes the staggering array of medical options available to women and men with fertility problems and assesses the toll - both financial and emotional - that the quest for a biological child often exacts from would-be parents. Becker interviewed hundreds of people over a period of years; their stories are presented here in their own words. Absorbing, informative, and in many cases moving, these stories address deep-seated notions about gender, self-worth, and the cultural ideal of biological parenthood. Becker moves beyond people's personal experiences to examine contemporary meanings of technology and the role of consumption in modern life. What emerges is a clear view of technology as culture, with technology the template on which issues such as gender, nature, and the body are being rewritten and continuously altered. The Elusive Embryo chronicles the history and development of reproductive technology, and shows how global forces in consumer culture have contributed to the industry's growth. Becker examines how increasing use of reproductive technology has changed ideas about "natural" pregnancy and birth. Discussing topics such as in vitro fertilization, how men and women "naturalize" the use of a donor, and what happens when new reproductive technologies don't work, Becker shows how the experience of infertility has become increasingly politicized as potential parents confront the powerful forces that shape this industry. The Elusive Embryo is accessible, well written, and well documented. It will be an invaluable resource for people using or considering new reproductive technologies as well as for social scientists and health professionals.   [brief]
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Title: Experiencing politics: a legislator's stories of government and health care
Author: McDonough, John E. (John Edward)
Published: University of California Press,  2000
Subjects: Politics | Public Policy | Medicine
Publisher's Description: John E. McDonough affords a rare glimpse into the practice of state politics in this insider's account of the fascinating interface between political science and real-life politics. A member of the Massachusetts House of Representatives for thirteen years and a skilled storyteller, McDonough eloquently weaves together stories of politics and policy with engaging theoretical models in a way that illuminates both the theory and the practice. By providing a link between scholarship and the world of experience, he communicates much about the essence of representative democracy. In the process, he demonstrates how politics extend beyond the public sphere into many aspects of life involving diverse values and interests. McDonough describes the nature of conflict, the role of interests, agenda setting, the nature and pace of change, the use of language, and more. Accessible, insightful, and original, his stories touch on a broad range of issues - including health care politics, campaigns, and elections; a street gang called the X-men; the death penalty; campaign finance reform, and tenants versus landlords. To the author, politics is everywhere and political dynamics are universal. While the setting for this book is one legislature, the lessons and insights are intended for everyone.   [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: Illness and culture in the postmodern age
Author: Morris, David B
Published: University of California Press,  1998
Subjects: Sociology | Philosophy | Medicine | Technology and Society | Anthropology | American Studies
Publisher's Description: We become ill in ways our parents and grandparents did not, with diseases unheard of and treatments undreamed of by them. Illness has changed in the postmodern era - roughly the period since World War II - as dramatically as technology, transportation, and the texture of everyday life. Exploring these changes, David B. Morris tells the fascinating story, or stories, of what goes into making the postmodern experience of illness different, perhaps unique. Even as he decries the overuse and misuse of the term "postmodern," Morris shows how brightly ideas of illness, health, and postmodernism illuminate one another in late-twentieth-century culture.Modern medicine traditionally separates disease - an objectively verified disorder - from illness - a patient's subjective experience. Postmodern medicine, Morris says, can make no such clean distinction; instead, it demands a biocultural model, situating illness at the crossroads of biology and culture. Maladies such as chronic fatigue syndrome and post-traumatic stress disorder signal our awareness that there are biocultural ways of being sick.The biocultural vision of illness not only blurs old boundaries but also offers a new and infinitely promising arena for investigating both biology and culture. In many ways Illness and Culture in the Postmodern Age leads us to understand our experience of the world differently.   [brief]
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Title: Birth as an American rite of passage
Author: Davis-Floyd, Robbie
Published: University of California Press,  1992
Subjects: Anthropology | Medical Anthropology | Women's Studies | Cultural Anthropology | Medicine | Gender Studies
Publisher's Description: Why do so many American women allow themselves to become enmeshed in the standardized routines of technocratic childbirth - routines that can be insensitive, unnecessary, and even unhealthy? And why, in spite of the natural childbirth movement, has hospital birth become even more intensely technologized? Robbie Davis-Floyd argues that these obstetrical procedures are rituals that reflect a cultural belief in the superiority of science over nature. Her interviews with 100 mothers and many health care professionals reveal in detail both the trauma and the satisfaction women derive from childbirth. She also calls for greater cultural and medical tolerance of the alternative beliefs of women who choose to birth at home.   [brief]
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Title: Prescription for profit: how doctors defraud Medicaid
Author: Jesilow, Paul 1950-
Published: University of California Press,  1993
Subjects: Science | Sociology | Medicine | Social Problems | Economics and Business
Publisher's Description: In this explosive exposé of our health care system, Paul Jesilow, Henry N. Pontell, and Gilbert Geis uncover the dark side of physician practice. Using interviews with doctors and federal, state, and private officials and extensive investigation of case files, they tell the stories of doctors who profit from abortions on women who aren't pregnant, of needless surgery, overcharging for services, and excessive testing.How can doctors, recipients of a sacred trust and sworn to the Hippocratic Oath, violate Medicaid so egregiously? The authors trace patterns of abuse to the program's inauguration in the mid 1960s, when government authorities, not individual patients, were entrusted with responsibility for payments. Determining fees and regulating treatment also became the job of government agencies, thus limiting the doctors' traditional role. Physicians continue to disagree with Medicare and Medicaid policies that infringe on their autonomy and judgment.The medical profession has not accepted the gravity or extent of some members' illegal behavior, and individual doctors continue to blame violations on subordinates and patients. In the meantime, program guidelines have grown more confusing, hamstringing efforts to detect, apprehend, and prosecute Medicaid defrauders. Failure to institute a coherent policy for fraud control in the medical benefit program has allowed self-serving and greedy practitioners to violate the law with impunity. Prescription for Profit is a shocking revelation of abuse within a once-hallowed profession. It is a book that every doctor, and every patient, needs to read this year.   [brief]
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Title: The caregiving dilemma: work in an American nursing home
Author: Foner, Nancy 1945-
Published: University of California Press,  1994
Subjects: Anthropology | Medical Anthropology | Social Problems | Medicine | Women's Studies
Publisher's Description: Along with increasing life expectancy comes the knowledge that many Americans will one day enter nursing homes. Who are the people who will care for us or for our relatives? Nancy Foner provides a major study of institutional care that focuses on nursing aides, who are the backbone of American nursing homes. She examines the strains and paradoxes facing nursing aides - asked, on the one hand, to provide compassionate care and, on the other, to cope with the pressures of the workplace and the institution.Aides are expected to look after patients, who are predominantly older women, with kindness and consideration, but nursing home regulations and bureaucratic forces often hinder even the best efforts to offer consistently supportive care. Positioned at the bottom of the nursing hierarchy, aides must cope with the needs of frail, dependent residents, pressures from patients' relatives and from their own families, and demands of supervisors and coworkers.Foner's detailed description and analysis of caregiving dilemmas, based on intensive field research in a New York facility, brings the perspective of the nursing aides to the fore. This is a timely contribution to the study of work, bureaucracy, and the future of an aging American population.   [brief]
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Title: Emptying beds: the work of an emergency psychiatric unit
Author: Rhodes, Lorna A. (Lorna Amarasingham)
Published: University of California Press,  1991
Subjects: Anthropology | Medical Anthropology | Psychiatry | Social Problems | Medicine
Publisher's Description: The work of inner-city emergency psychiatric units might best be described as "medicine under siege." Emptying Beds is the result of the author's two-year immersion in one such unit and its work. It is an account of the strategies developed by a staff of psychiatrists, social workers, nurses, and ot . . . [more]
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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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