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Healthcare ethics is not just about decisions made at the bedside. It is also about decisions made in executive offices and in boardrooms. Business Ethics in Healthcare offers perspectives that can assist healthcare managers achieve the highest ethical standards as they face their roles as healthcare providers, employers, and community service organizations. Weber suggests guidelines and criteria based on the understanding that the healthcare organization is committed to patients' rights, to careful stewardship of resources, to just working conditions for employees, and to service to the community.
As Weber shows, addressing business ethics issues in a healthcare organization starts with complying with relevant laws and regulations. As a provider of high quality patient care with limited resources, it needs to be able to distinguish between the right way and the wrong way of taking cost into consideration when making decisions about patient care practices. As employer, the organization needs to use good criteria for determining wages and salaries, to know how to make fair decisions about downsizing, and to respond most appropriately to union organizing efforts and employee strikes. As a community service organization, it has particular responsibilities to the community in the way it advertises, how it disposes of medical waste, and the types of mergers it enters into.
Leonard J. Weber is on the faculty of the University of Detroit, Mercy. He has published over 70 articles and is the principal author of the "Case Studies in Ethics" column in Clinical Leadership & Management Review. He serves as an ethics consultant to several healthcare organizations and is a past president of the Medical Ethics Resource Network of Michigan.
Medical Ethics Series -- David H. Smith and Robert M. Veatch, editors
Doctors, Specialization, and Urban Change in Philadelphia, 1900-1940
Unevenly distributed resources and rising costs have become enduring problems in the American health care system. Health care is more expensive in the United States than in other wealthy nations, and access varies significantly across space and social classes. James A. Schafer Jr. shows that these problems are not inevitable features of modern medicine, but instead reflect the informal organization of health care in a free market system in which profit and demand, rather than social welfare and public health needs, direct the distribution and cost of crucial resources.The Business of Private Medical Practice is a case study of how market forces influenced the office locations and career paths of doctors in one early twentieth-century city, Philadelphia, the birthplace of American medicine. Without financial incentives to locate in poor neighborhoods, Philadelphia doctors instead clustered in central business districts and wealthy suburbs. In order to differentiate their services in a competitive marketplace, they also began to limit their practices to particular specialties, thereby further restricting access to primary care. Such trends worsened with ongoing urbanization.Illustrated with numerous maps of the Philadelphia neighborhoods he studies, Schafer’s work helps underscore the role of economic self-interest in shaping the geography of private medical practice and the growth of medical specialization in the United States.
Inventing a Pathology of Catastrophe for Holocaust Survival [The Limits of Medical Knowledge and Historical Memory in France]
In this extraordinary study, Michael Dorland explores sixty years of medical attempts by French doctors (mainly in the fields of neuropsychiatry and psychoanalysis) to describe the effects of concentration camp incarceration on Holocaust survivors.
Dorland begins with a discussion of the liberation of concentration camp survivors, their stay in deportation camps, and eventual return to France, analyzing the circulation of mainly medical (neuropsychiatric) knowledge, its struggles to establish a symptomology of camp effects, and its broadening out into connected medical fields such as psychoanalysis. He then turns specifically to the French medical doctors who studied Holocaust survivors, and he investigates somatic, psychological, and holistic conceptions of survivors as patients and human beings.
The final third of the book offers a comparative look at the "psy-science" approach to Holocaust survival beyond France, particularly in the United States and Israel. He illuminates the peculiar journey of a medical discourse that began in France but took on new forms elsewhere, eventually expanding into nonmedical fields to create the basis of the "traumato-culture" with which we are familiar today.
Embedding his analysis of different medical discourses in the sociopolitical history of France in the twentieth century, he also looks at the French Jewish Question as it affected French medicine, the effects of five years of Nazi Occupation, France's enthusiastic collaboration, and the problems this would pose for postwar collective memory.
Vol. 23 (2004) through current issue
The Canadian Journal on Aging is a refereed, quarterly publication of the Canadian Association on Gerontology. It publishes manuscripts on aging concerned with biology, educational gerontology, health sciences, psychology, social sciences, and social policy and practice.
La Revue canadienne du vieillissement, revue trimestrielle dotée d’un comité de lecture; est l’organe de l’Association canadienne de gérontologie. La revue publie des articles sur le vieillissement dans les disciplines suivantes: biologie, gérontologie éducative, sciences de la santé, psychologie, sciences sociales et politiques et pratiques sociales. Les manuscrits sont acceptés ou refusés sur la recommandation des rédacteurs représentant chacune des cinq sections de l’ACG, et après consultation avec les membres du comité de lecture.
Blessings and Battles
The "oldest old," individuals aged 85 and above, are the most rapidly growing segment of American society. And although more than a third of cancer occurs in people over 75 years of age, their tumors are less fully diagnosed and often less fully treated than those in younger patients. Ageism may account for this discrepancy—why intervene if an older man or woman with cancer doesn't have long to live anyway? Yet older people often tolerate chemotherapy, surgery, and radiation as well as younger patients, while continuing to maintain their quality of life for years to come.
The lack of clinical trials among this age group results in a deficit of knowledge regarding how to treat cancer in older adults. Little has been written to guide clinicians, social scientists, families, and individuals. In Cancer in the Lives of Older Americans: Blessings and Battles, Sarah H. Kagan writes from the perspective of more than twenty years of practice, inquiry, and education as a nurse. She uses anecdotes and case studies to illustrate important points about cancer among older adults.
The book follows the story of Mrs. Eck, a woman in her 80s diagnosed with pancreatic cancer. Mrs. Eck's situation sets the stage for a discussion of cancer, which too often focuses on cells and drugs, diagnoses and prognoses without looking more closely at the people who are experiencing the disease. Chapters offer varied assessments of what it means to be old and have cancer in our society, as Kagan explores other real experiences of cancer for older adults alongside information that will prove essential to patients, their families, scholars, and clinicians.
What happens when a Cherokee patient summons a medicine man to the hospital, or when an Anglo nurse refuses to take orders from a Japanese doctor? Why do Asian patients rarely ask for pain medication, while Mediterranean patients seem to seek relief for even the slightest discomfort?
If the goal of the American medical system is to provide optimal care for all patients, healthcare providers must understand cultural differences that create conflicts and misunderstandings and can result in inferior medical care. Geri-Ann Galanti's updated classic, Caring for Patients from Different Cultures, is even more comprehensive than the first three editions, containing new appendices for quick reference, an expanded and updated bibliography with Internet resources, and a detailed index.
Caring for Patients from Different Cultures contains more than 200 case studies illustrating crosscultural misunderstanding and culturally competent health care. The chapters cover a wide range of topics, including birth, end of life, traditional medicine, mental health, pain, religion, and multicultural staff issues. The case studies illustrate important concepts from the fields of cultural diversity and medical anthropology. This volume is an important resource for nurses and physicians in achieving cultural competency.
Professional Intimacy in Hospital Nursing
Every day, hospital nurses must negotiate intimate trust and intimate conflict in an effort to provide quality health care. However, interactions between nurses and patients—which often require issues of privacy—are sometimes made more uncomfortable with inappropriate behavior, as when a patient has a racist and/or sexist outburst. Not all nurses are prepared to handle such intimacy, but they can all learn how to "be caring."
In Catheters, Slurs, and Pickup Lines, Lisa Ruchti carefully examines this fragile relationship between intimacy and professional care, and provides a language for patients, nurses, and administrators to teach, conduct, and advocate for knowledgeable and skilled intimate care in a hospital setting. She also recommends best training practices and practical and effective policy changes to handle conflicts.
Ruchti shows that "caring" is not just a personality characteristic but is work that is structured by intersections of race, gender, and nationality.
Race, Science, and Ideology
Raymond Cattell, the father of personality trait measurement, was one of the most influential psychologists in the twentieth century, with a professional career that spanned almost seventy years. In August 1997, the American Psychological Association announced that Cattell had been selected the recipient of the American Psychological Foundation Gold Medal Award for Life Achievement in Psychological Science. Then, only two days before the scheduled ceremony, the APF abruptly postponed the presentation of the award due to concerns involving Cattell's views on racial segregation and eugenics. In addition to his mainstream research, in his publications Cattell had also posited evolutionary progress as the ultimate goal of human existence and argued that scientific criteria should be used to distinguish "successful" from "failing" racial groups so that the latter might be gradually "phased out" by non-violent methods such as regulation of birth control._x000B__x000B_The Cattell Controversy discusses the controversy that arose within the field in response to the award's postponement, after which Cattell withdrew his name from consideration for the award but insisted that his position had been distorted by taking statements out of context. Reflecting on these events, William H. Tucker concludes with a discussion of the complex question of whether and how a scientist's ideological views should ever be a relevant factor in determining the value of his or her contributions to the field.
From the Indiana Experiment to the Human Genome Era
In 1907, Indiana passed the world's first involuntary sterilization law based on the theory of eugenics. In time, more than 30 states and a dozen foreign countries followed suit. Although the Indiana statute was later declared unconstitutional, other laws restricting immigration and regulating marriage on "eugenic" grounds were still in effect in the U.S. as late as the 1970s. A Century of Eugenics in America assesses the history of eugenics in the United States and its status in the age of the Human Genome Project. The essays explore the early support of compulsory sterilization by doctors and legislators; the implementation of eugenic schemes in Indiana, Georgia, California, Minnesota, North Carolina, and Alabama; the legal and social challenges to sterilization; and the prospects for a eugenics movement basing its claims on modern genetic science.