The Social Medicine Reader

The Social Medicine Reader

By: Ronald P. Strauss (editor), Gail E. Henderson (editor), Sue E. Estroff (editor), Nancy M. P. King (editor), Larry R. Churchill (editor)Hardback

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To meet the needs of the rapidly changing world of health care, future physicans and health care providers will need to be trained to become wiser scientists and humanists in order to understand the social and moral as well as technological aspects of health and illness. The Social Medicine Reader is designed to meet this need. Based on more than a decade of teaching social medicine to first-year medical students at the pioneering Department of Social Medicine at the University of North Carolina, The Social Medicine Reader defines the meaning of the social medicine perspective and offers an approach for teaching it. Looking at medicine from a variety of perspectives, this anthology features fiction, medical reports, scholarly essays, poetry, case studies, and personal narratives by patients and doctors-all of which contribute to an understanding of how medicine and medical practice is profoundly influenced by social, cultural, political, and economic forces. What happens when a person becomes a patient? How are illness and disability experienced? What causes disease? What can medicine do? What constitutes a doctor/patient relationship? What are the ethical obligations of a health care provider? These questions and many others are raised by The Social Medicine Reader, which is organized into sections that address how patients experience illness, cultural attitudes toward disease, social factors related to health problems, the socialization of physicians, the doctor/patient relationship, health care ethics and the provider's role, medical care financing, rationing, and managed care.

About Author

Gail E. Henderson, Associate Professor of Social Medicine and Adjunct Professor of Sociology at the University of North Carolina at Chapel Hill, is the author of The Chinese Hospital: A Socialist Work Unit. Nancy M. P. King, Associate Professor of Social Medicine at the University of North Carolina at Chapel Hill, is the author of Making Sense of Advance Directives. Ronald P. Strauss is Professor of Dental Ecology and Social Medicine at the University of North Carolina at Chapel Hill and is author of numerous articles on social and ethical issues in the care of chronic illness. Sue E. Estroff is Professor of Social Medicine and Adjunct Professor of Anthropology and Psychiatry at the University of North Carolina at Chapel Hill. She is the author of Making It Crazy: An Ethnography of Psychiatric Clients in an American Community. Larry R. Churchill is Professor of and Chair of the Department of Social Medicine at the University of North Carolina at Chapel Hill. He is the author of Self-Interest and Universal Health Care: Why Well-Insured Americans Should Support Coverage for Everyone and Rationing Health Care in America: Perceptions and Principles of Justice.


Preface ix Introduction 1 Part I. A Cultural Perspective of Experiences of Illness, Disability, nd Deviance Introduction / Sue Estroff 6 1. Culture, Health, and Illness 12 The Nature of Suffering and the Goals of Medicine / Eric J. Cassell 13 Cancer, Control, and Causality: Talking about Cancer in a Working-Class Community / Martha Belshem 23 Coming to Terms with Advanced Breast Cancer: Black Women's Narratives from Eastern North Carolina / Holly F. Matthews, Donald R. Lannin, and James P. Mitchell 43 2. Illness Experiences and Illness Narratives 61 The Deer at Providencia / Annie Dillard 63 The Cost of Appearances / Arthur Frank 66 Silver Water / Amy Bloom 69 3. Experiences of Deviance, Chronic Illness, and Disability 75 Self, Identity, and the Naming Question: Reflections on the Language of Disability / Irving Kenneth Zola 77 Finch the Spastic Speaks / Gordon Weaver 87 Tell Me, Tell Me / Irving Kenneth Zola 95 Part II. The Influence of Social Factors on Health and Illness Introduction / Gail E. Henderson 100 1. The Relationship between Social Class, Race/Ethnicity, and Health 108 Socioeconomic Inequalities in Health: No Easy Solution / Nancy E. Adler 109 "Where Crowded Humanity Suffers and Sickens": The Banes Family and Their Neighborhood / Laurie K. Abraham 121 One Drop of Blood / Lawrence Wright 131 2. Gender and Health 142 Women Have Headaches, Men Have Backaches: Patterns of Illness in an Appalachian Community / Claire F. Horton 143 Spence + Lila (excerpts) / Bobbie Ann Mason 156 The Mother-in-Law / Doris Betts 163 3. Old Age 167 Trends, Issues, Perspectives, and Values for the Aging of the Baby Boom Cohorts (excerpts) / John M. Cornman and Eric R. Kingson 168 What Do Children Owe Elderly Parents? / Daniel Callahan 175 Decision Making, Responsibility, and Advocacy in Geriatric Medicine: Physician Dilemmas with Elderly in the Community / Sharon R. Kaufman 184 We Are Nighttime Travelers / Ethan Canin 196 Part III. The Culture of Medicine and Medical Practice Introduction / Ronald P. Strauss 205 The Socialization of Physicians 209 Basic Clinical Skills: The First Encounters / Melvin Konner 210 Becoming a Doctor: Critical-Incident Reports from Third-Year Medical Students / William Branch, Richard J. Pels, Robert S. Lawrence, and Ronald Arky 223 Invasions / Perri Klass 227 Ethical Dilemmas fro House Staff Physicians: The Care of Critically Ill and Dying Patients / William Winkenwerder Jr. 230 A Student's View of a Medical Teaching Exercise / Abenaa Brewster 236 The Libby Zion Case: One Step Forward or Two Steps Backward? / David A. Asch and Ruth M. Parker 238 2. Medical Practice in Social Context 244 Presidential Address: The Boundaries of Medicine / Donald W. Seldin 244 The Boundaries of Medicine / Gerald T. Perkoff 254 The Changing Demography of the Medical Profession / Arnold S. Relman 263 Medicine is No Longer a Man's Profession: Or, When the Men's Club Goes Coed It's Time to Change the Regs / Carola Eisenberg 266 The Doctors of Hoyland / Sir Arthur Conan Doyle 270 3. Relationships between Doctors and Patients 277 The Basic Models of the Doctor-Patient Relationship / Thomas S. Szasz and Marc H. Hollender 278 Facing Our Mistakes / David Hilfiker 287 Simple Living and Hard Choices / Maureen A. Flannery 293 The Paid Nurse / William Carlos Williams 300 Part IV. Health Care Ethics and the Provider's Role Introduction / Nancy M. P. King 304 1. The Provider-Patient Relationship 309 Bioethics in Social Context / Larry R. Churchill 310 The Use of Force / William Carlos Williams 320 Case Study: The "Student Doctor" and a Wary Patient / Marc D. Basson, Gerald Dworkin, and Eric J. Cassell 323 Truth Telling to the Patient / Antonella Surbone 326 Is Truth Telling to the Patient a Cultural Artifact? / Edmund D. Pellegrino 330 Offering Truth: One Ethical Approach to the Uninformed Cancer Patient / Benjamin Freedman 333 What the Doctor Said / Raymond Carver 341 Informed Consent, Cancer, and Truth in Prognosis / George J. Annas 341 Swapping Stories: A Matter of Ethics / Judith Andre 346 Case Study: Please Don't Tell / Leonard Fleck and Marcia Angell 349 2. Interests in Conflict 353 Cesareans and Samaritans / Nancy K. Rhoden 354 Justified Limits on Refusing Intervention / Frank A. Chervenak and Laurence B. McCullough 365 Faith (Healing), Hope, and Charity at the FDA: The Politics of AIDS Drug Trials / George J. Annas 375 Case Study: The Doctor's Unproven Beliefs and the Subjects Informed Choice / Don Marquis 386 3. Choices about Treatment 391 Disconnecting a Ventilator at the Request of a Patient Who Knows He Will Then Die: The Doctor's Anguish / Miles J. Edwards and Susan W. Tolle 393 The Last Words of My English Grandmother / William Carlos Williams 398 Death and Dignity: A Case of Individualized Decision Making / Timothy E. Quill 399 Informed Demand for "Non-Beneficial" Medical Treatment / Steven H. Miles 403 The Case of Helga Wanglie: A New Kind of "Right to Die" Case / Marcia Angell 407 Part V. Medical Care Financing, Rationing, and Managed Care Introduction / Larry R. Churchill 410 1. Medical Care Financing 415 Paying for Medical Care in America / Donald L. Madison 415 Reforming the Health Care System: The Universal Dilemma / Uwe E. Reinhardt 446 2. Rationing: The Dilemmas of Fair Distribution 460 The "Rationing" of Medical Care / Victor R. Fuchs 461 The Prostitute, the Playboy, and the Poet: Rationing Schemes for Organ Transplantation / George J. Annas 464 Ethics of Queuing for Coronary Artery Bypass Grafting in Canada / Jafna L. Cox 469 Rationing in Practice: The Case of In Vitro Fertilisation / Sharon Redmayne and Rudolf Klein 475 3. Managed Care and the Physician's Changing Role 481 Hippocrates and the Health Maintenance Organization: A Discussion of Ethical Issues / Gail Povar and Jonathan Moreno 482 Physicians and Business Managers: A Clash of Cultures / Arnold S. Relman 491 Preserving the Physician-Patient Relationship in the Era of Managed Care / Ezekiel J. Emanuel and Nancy Neveloff Dubler 495 Bibliography 510 Acknowledgment of Copyrights 514 Index to Authors 517

Product Details

  • ISBN13: 9780822319573
  • Format: Hardback
  • Number Of Pages: 528
  • ID: 9780822319573
  • ISBN10: 0822319578

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