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Improving Health Care for Everyone
Affirmative action programs have significantly changed American medicine for the better, not only in medical school admissions and access to postgraduate training but also in bringing a higher quality of health care to all people. James L. Curtis approaches this important transition from historical, statistical, and personal perspectives. He tells how over the course of his medical education and career as a psychiatrist and professor--often as the first or only African American in his cohort--the status of minorities in the medical professions grew from a tiny percentage to a far more equitable representation of the American population. Advancing arguments from his earlier book, Blacks, Medical Schools, and Society, Curtis evaluates the outcomes of affirmative action efforts over the past thirty years. He describes formidable barriers to minority access to medical-education opportunities and the resulting problems faced by minority patients in receiving medical treatment. His progress report includes a review of two thousand minority students admitted to U.S. medical schools in 1969, following them through graduation and their careers, comparing them with the careers of two thousand of their nonminority peers. These samples provide an important look at medical schools that, while heralding dramatic progress in physician education and training opportunity, indicates much room for further improvement. A basic hurdle continues to face African Americans and other minorities who are still confined to segregated neighborhoods and inferior school systems that stifle full scholastic development. Curtis urges us as a nation to develop all our human resources through an expansion of affirmative action programs, thus improving health care for everyone. James L. Curtis is Clinical Professor Emeritus of Psychiatry, Columbia University College of Physicians and Surgeons.
A Practical Guide for Global Health Workers
Written by authors who speak directly from their years of personal and professional experience with health projects in Africa, this book provides an integrated historical, social, political, economic, and health introduction to a series of African countries. It also offers a comprehensive view of major health issues for those aiming to undertake humanitarian and global health work in Africa.
In the introductory chapter, the editors discuss the concepts of globalism and humanitarianism, and provide a framework for thinking about global health. They introduce readers to significant aspects of African history and agencies that play major roles in global health work in Africa. The "Tips for Travelers to Africa" chapter provides a wealth of information on preparing for travel to Africa and working successfully and effectively in African cultures.
Individual chapters on Botswana, Ghana, The Maghreb, Rwanda, South Africa, Tanzania, and Uganda focus on key health or environmental issues, projects, and solutions unique to each country. Written jointly by U.S. and African medical personnel participating in major health initiatives, the chapters offer vibrant accounts of work on leading causes of disease and death or environmental problems.
This is a vivid, thought-provoking and fascinating text on some contentious issues in contemporary medical ethics. The book acknowledges the contribution of ìAfrican traditionî and Western scholarship to the development of medical ethics as a university discipline. It questions the lack of consensus around such biomedical issues as euthanasia and traditional medicine. In many countries, the failure has resulted in public outcries. Its thrust centres on the nexus of practice and theory, and the importance of pragmatism and critical questioning in dealing with different cases on and around biomedicine. Its virtue is its significant shift from the traditional positions on selected biomedical issues to a more rigorous, pragmatic and critical questioning and understanding of the reasoning and positions of all involved and/or affected parties.
Culture, Race, and Identity
Do people of differing ethnicities, cultures, and races view medicine and bioethics differently? And, if they do, should they? Are doctors and researchers taking environmental perspectives into account when dealing with patients? If so, is it done effectively and properly? In African American Bioethics, Lawrence J. Prograis Jr. and Edmund D. Pellegrino bring together medical practitioners, researchers, and theorists to assess one fundamental question: Is there a distinctive African American bioethics? The book's contributors resoundingly answer yesùyet their responses vary. They discuss the continuing African American experience with bioethics in the context of religion and tradition, work, health, and U.S. society at largeùfinding enough commonality to craft a deep and compelling case for locating a black bioethical framework within the broader practice, yet recognizing profound nuances within that framework. As a more recent addition to the study of bioethics, cultural considerations have been playing catch-up for nearly two decades. African American Bioethics does much to advance the field by exploring how medicine and ethics accommodate differing cultural and racial norms, suggesting profound implications for growing minority groups in the United States.
Medical Error and the Ethics of Forgiveness
Medical error is a leading problem of health care in the United States. Each year, more patients die as a result of medical mistakes than are killed by motor vehicle accidents, breast cancer, or AIDS. While most government and regulatory efforts are directed toward reducing and preventing errors, the actions that should follow the injury or death of a patient are still hotly debated. According to Nancy Berlinger, conversations on patient safety are missing several important components: religious voices, traditions, and models. In After Harm, Berlinger draws on sources in theology, ethics, religion, and culture to create a practical and comprehensive approach to addressing the needs of patients, families, and clinicians affected by medical error. She emphasizes the importance of acknowledging fallibility, telling the truth, confronting feelings of guilt and shame, and providing just compensation. After Harm adds important human dimensions to an issue that has profound consequences for patients and health care providers.
Clinical Practice and the Subject of the Unconscious
After Lacan combines abundant case material with graceful yet sophisticated theoretical exposition in order to explore the clinical practice of Lacanian psychoanalysis. Focusing on the groundbreaking clinical treatment of psychosis that Gifric (Groupe Interdisciplinaire Freudien de Recherches et d’Interventions Cliniques et Culturelles) has pioneered in Quebec, the authors discuss how Lacanians theorize psychosis and how Gifric has come to treat it analytically. Chapters are devoted to the general concepts and key terms that constitute the touchstones of the early phase of analytic treatment, elaborating their interrelations and their clinical relevance. The second phase of analytic treatment is also discussed, introducing a new set of terms to understand transference and the ethical act of analysis in the subject’s assumption of the Other’s lack. The concluding chapters broaden discussion to include the key psychic structures that describe the organization of subjectivity and thereby dictate the terms of analysis: not just psychosis, but also perversion and obsessional and hysterical neurosis.
The Life and Times of the Human Cadaver
What will become of our earthly remains? What happens to our bodies during and after the various forms of cadaver disposal available? Who controls the fate of human remains? What legal and moral constraints apply? Legal scholar Norman Cantor provides a graphic, informative, and entertaining exploration of these questions. After We Die chronicles not only a corpse's physical state but also its legal and moral status, including what rights, if any, the corpse possesses.
In a claim sure to be controversial, Cantor argues that a corpse maintains a "quasi-human status" granting it certain protected rights -- both legal and moral. One of a corpse's purported rights is to have its predecessor's disposal choices upheld. After We Die reviews unconventional ways in which a person can extend a personal legacy via their corpse's role in medical education, scientific research, or tissue transplantation. This underlines the importance of leaving instructions directing post-mortem disposal. Another cadaveric right is to be treated with respect and dignity. After We Die outlines the limits that "post-mortem human dignity" poses upon disposal options, particularly the use of a cadaver or its parts in educational or artistic displays.
Contemporary illustrations of these complex issues abound. In 2007, the well-publicized death of Anna Nicole Smith highlighted the passions and disputes surrounding the handling of human remains. Similarly, following the 2003 death of baseball great Ted Williams, the family in-fighting and legal proceedings surrounding the corpse's proposed cryogenic disposal also raised contentious questions about the physical, legal, and ethical issues that emerge after we die. In the tradition of Sherwin Nuland's How We Die, Cantor carefully and sensitively addresses the post-mortem handling of human remains.
How Health Became the New Morality
“[A]n important new book.” –Psychology Today
In this deeply considered meditation on aging in Western culture, Jan Baars argues that, in today’s world, living longer does not necessarily mean living better. He contends that there has been an overall loss of respect for aging, to the point that understanding and “dealing with” aging people has become a process focused on the decline of potential and the advance of disease rather than on the accumulation of wisdom and the creation of new skills. To make his case, Baars takes the reader on a survey of contemporary theories of aging, confronting them with their philosophical foundations. He draws on the works of Socrates, Plato, Aristotle, and Cicero, as well as on such contemporary philosophers as Husserl, Heidegger, Habermas, and Foucault. Aging and the Art of Living shows how people in the classical period—less able to control health hazards—had a far better sense of the provisional nature of living, which led to a philosophical and religious emphasis on cultivating the art of living and the idea of wisdom. This is not to say that modern society’s assessments of aging are insignificant, but they do need to balance an emphasis on the measuring of age with the concept of "living in time." Gerontologists, philosophers, and students will find Baars' discussion to be a powerful, perceptive conversation-starter.
Dementia, Friendship, and Flourishing Communities
Never in human history have there been so many people entering old age—roughly one-third of whom will experience some form of neurodegeneration as they age. This seismic demographic shift will force us all to rethink how we live and deal with our aging population. Susan H. McFadden and John T. McFadden propose a radical reconstruction of our societal understanding of old age. Rather than categorize elders based on their respective cognitive consciousness, the McFaddens contend that the only humanistic, supportive, and realistic approach is to find new ways to honor and recognize the dignity, worth, and personhood of those journeying into dementia. Doing so, they argue, counters the common view of dementia as a personal tragedy shared only by close family members and replaces it with the understanding that we are all living with dementia as the baby boomers age, particularly as early screening becomes more common and as a cure remains elusive. The McFaddens' inclusive vision calls for social institutions, especially faith communities, to search out and build supportive, ongoing friendships that offer hospitality to all persons, regardless of cognitive status. Drawing on medicine, social science, philosophy, and religion to provide a broad perspective on aging, Aging Together offers a vision of relationships filled with love, joy, and hope in the face of a condition that all too often elicits anxiety, hopelessness, and despair.