Saving Babies? The Consequences of Newborn Genetic Screening
Stefan Timmermans and Mara Buchbinder
It has been close to six decades since Watson and Crick discovered the structure of DNA and more than ten years since the human genome was decoded. Today, through the collection and analysis of a small blood sample, every baby born in the United States is screened for more than fifty genetic disorders. Though the early detection of these abnormalities can potentially save lives, the test also has a high percentage of false positives—inaccurate results that can take a brutal emotional toll on parents before they are corrected. Now some doctors are questioning whether the benefits of these screenings outweigh the stress and pain they sometimes produce. In Saving Babies?, Stefan Timmermans and Mara Buchbinder evaluate the consequences and benefits of state-mandated newborn screening—and the larger policy questions they raise about the inherent inequalities in American medical care that limit the effectiveness of this potentially lifesaving technology.
Drawing on observations and interviews with families, doctors, and policy actors, Timmermans and Buchbinder have given us the first ethnographic study of how parents and geneticists resolve the many uncertainties in screening newborns. Ideal for scholars of medicine, public health, and public policy, this book is destined to become a classic in its field.
Clowns and Jokers Can Heal Us: Comedy and Medicine (Perspectives in Medical Humanities)
Albert Howard Carter III
Howard Carter, PhD is adjunct professor in the Department of Social Medicine.
In his most recent book Clowns and Jokers Can Heal Us, he writes of the humor
that can be found in medicine and how it can help both patients and medical
practitioners establish a normalcy in often chaotic and surreal circumstances.
Dr. Carter draws upon his experiences as an ER volunteer, and is himself a cancer
His other books include Our Human Hearts: A Medical and Cultural Journal; Rising
from the Flames: The Experience of the Severely Burned, and First Cut: A Season
in the Human Anatomy Lab.
Hobbes: Prince of Peace
Thomas Hobbes was the first great English political philosopher. His work excited intense controversy among his contemporaries and continues to do so in our own time. In this masterly introduction to his work, Bernard Gert provides the first account of Hobbes’s political and moral philosophy that makes it clear why he is regarded as one of the best philosophers of all time in both of these fields. In a succinct and engaging analysis the book illustrates that the commonly accepted view of Hobbes as holding psychological egoism is not only incompatible with his account of human nature but is also incompatible with the moral and political theories that he puts forward. It also explains why Hobbes’s contemporaries did not accept his explicit claim to be providing a natural law account of morality.
Gert shows that for Hobbes, civil society is established by a free-gift of their right of nature by the citizens; it does not involve a mutual contract between citizens and sovereign. As injustice involves breaking a contract, the sovereign cannot be unjust; however, the sovereign can be guilty of ingratitude, which is immoral. This distinction between injustice and immorality is part of a sophisticated and nuanced political theory that is in stark contrast to the reading often incorrectly attributed to Hobbes that “might makes right”. It illustrates how Hobbes’s goal of avoiding civil war provides the key to understanding his moral and political philosophy.
Hobbes: Prince of Peace is likely to become the classic introduction to the work of Thomas Hobbes and will be a valuable resource for scholars and students seeking to understand the importance and relevance of his work today.
Hugh Williamson: Physician, Patriot, and Founding Father
George F. Sheldon
Hugh Williamson (1735-1819) was a physician, a member of the educated intelligentsia in colonial America, and a signer of the US Constitution. Although he is one of the lesser-known Founding Fathers, he has been likened to Benjamin Franklin for his breadth of interest spanning science, medicine, government public policy, and Hamiltonian capitalism. His range of accomplishments was prodigious. Before the Revolutionary War, he was among the planners of the Boston Tea Party. When war broke out, he acted as a spy and a courier for Benjamin Franklin, and later became surgeon general of the North Carolina Revolutionary War Militia. After the war, he served in the North Carolina legislature, the Constitutional Convention, and the first US House of Representatives. In this first book-length biography of Hugh Williamson, Dr George Sheldon presents an appealing portrait of an often overlooked colonial patriot and an important member of the medical establishment in 18th-century America. Sheldon reveals many interesting details about Williamson's multifaceted life. He was a member of the University of Pennsylvania's first graduating class. He served as a courier in Europe before and during the Revolutionary War, arousing the suspicions of both the British and a contingent of Americans that he was a double agent. After the war Williamson not only served as a physician and politician in North Carolina but as the first secretary of the board of governors of the University of North Carolina, the first nondenominational institution of higher education in America. His expertise ranged from the cause of the 1792 fever outbreak in North Carolina and the correct installation of lightning rods, to work with George Washington on the draining of the Great Dismal Swamp and management of the Bloomingdale estate of his wife's family, which included much of present-day New York City. For anyone interested in the important contributors to early American history, this excellent biography of Hugh Williamson will be indispensable reading
In the Valley of the Kings
A practicing physician, Terrence Holt has written prize-winning stories for publications like TriQuarterly and Zoetrope but has operated, until now, under the literary radar. This collection, which gathers one novella and seven stories written over an entire career, leaps across genres and millennia—from small-town America to the depths of space—exploring the dark corners of human nature in a style that recalls the nineteenth-century American masters and the moral complexity of Conrad. Whether chronicling a plague that ravages a New England town and threatens the human race, an Egyptologist’s obsessive quest for a tomb that holds the secrets of immortality, or the anguish of a son who keeps his father’s beating heart in a jar, Holt conjures up mysterious worlds in which life joins death in a danse macabre of brilliantly inventive language, wicked wit, and spectacular imagination. A stunning debut by one of our most promising writers.
Working Virtue: Virtue Ethics and Contemporary Moral Problems
Rebecca L. Walker, Philip J. Ivanhoe (eds.)
Working Virtue is the first substantial collective study of virtue theory and contemporary moral problems. Leading figures in ethical theory and applied ethics discuss topics in bioethics, professional ethics, ethics of the family, law, interpersonal ethics, and the emotions.
Virtue ethics is centrally concerned with character traits or virtues and vices such as courage (cowardice), kindness (heartlessness), and generosity (stinginess). These character traits must be looked to in any attempt to understand which particular actions are right or wrong and how we ought to live our lives. As a theoretical approach, virtue ethics has made an impressive comeback in relatively recent history, both posing an alternative to, and, in some ways, complementing well-known theoretical stances such as utilitarianism and deontology. Yet there is still very little material available that presents virtue-ethical approaches to practical contemporary moral problems, such as what we owe distant strangers, our parents, or even non-human animals. This book fills the gap by dealing with these and other pressing moral problems in a clear and theoretically nuanced manner.
The contributors offer a variety of perspectives, including pluralistic, eudaimonistic, care-theoretical, Chinese, comparative, and stoic. This variety allows the reader to appreciate not only the wide range of topics for which a virtue-ethical approach may be fitting, but also the distinctive ways in which such an approach may be manifested.
CT Suite: The Work of Diagnosis in the Age of Noninvasive Cutting
Barry F. Saunders
In CT Suite the doctor and anthropologist Barry F. Saunders provides an ethnographic account of how a particular diagnostic technology, the computed tomographic (CT) scanner, shapes social relations and intellectual activities in and beyond the CT suite, the unit within the diagnostic radiology department of a large teaching hospital where CT images are made and interpreted. Focusing on how expertise is performed and how CT images are made into diagnostic evidence, he concentrates not on the function of CT images for patients but on the function of the images for medical professionals going about their routines. Yet Saunders offers more than insider ethnography. He links diagnostic work to practices and conventions from outside medicine and from earlier historical moments. In dialogue with science and technology studies, he makes a significant contribution to scholarship on the visual cultures of medicine.
Saunders’s analyses are informed by strands of cultural history and theory including art historical critiques of realist representation, Walter Benjamin’s concerns about violence in “mechanical reproduction,” and tropes of detective fiction such as intrigue, the case, and the culprit. Saunders analyzes the diagnostic “gaze” of medical personnel reading images at the viewbox, the two-dimensional images or slices of the human body rendered by the scanner, methods of archiving images, and the use of scans as pedagogical tools in clinical conferences. Bringing cloistered diagnostic practices into public view, he reveals the customs and the social and professional hierarchies that are formulated and negotiated around the weighty presence of the CT scanner. At the same time, by returning throughout to the nineteenth-century ideas of detection and scientific authority that inform contemporary medical diagnosis, Saunders highlights the specters of the past in what appears to be a preeminently modern machine.
The Social Medicine Reader, Second Edition:
Volume One: Patients, Doctors, and Illness
Nancy M. P. King, Ronald P. Strauss, Larry R. Churchill, Sue E. Estroff, Gail E. Henderson and Jonathan Oberlander
A woman with what is quite probably a terminal illness must choose between courses of treatment based on contradictory diagnoses. A medical student causes acute pain in his patients as he learns to insert a central line. One doctor wonders how to react when a patient asks him to pray with her; another struggles to come to terms with his mistakes. A physician writes in a prominent medical journal about facilitating a dying woman’s wish to end her life on her own terms; letters to the editor reflect passionate responses both in support of and in opposition to his actions. These experiences and many more are vividly rendered in Patients, Doctors, and Illness, which brings together nineteen pieces that appeared in the first edition of The Social Medicine Reader and eighteen pieces new to this edition. This volume examines the roles and training of health care professionals and their relationship with patients, ethics in health care, and end-of-life experiences and decisions. It includes fiction and nonfiction narratives and poetry; definitions and case-based discussions of moral precepts in health care, such as truth telling, informed consent, privacy, and autonomy; and readings that provide legal, ethical, and practical perspectives on many familiar but persistent ethical and social questions raised by illness and care.
The Social Medicine Reader, Second Edition:
Volume Two: Social and Cultural Contributions to Health, Difference, and Inequality
Gail E. Henderson, Sue E. Estroff, Larry R. Churchill, Nancy M. P. King, Jonathan Oberlander and Ronald P. Strauss
Ranging from a historical look at eugenics to an ethnographic description of parents receiving the news that their child has Down syndrome, from analyses of inequalities in the delivery of health services to an examination of the meaning of race in genomics research, and from a meditation on the loneliness of the long-term caregiver to a reflection on what children owe their elderly parents, this volume explores health and illness. Social and Cultural Contributions to Health, Difference, and Inequality brings together seventeen pieces new to this edition of The Social Medicine Reader and five pieces that appeared in the first edition. It focuses on how difference and disability are defined and experienced in contemporary America, how the social categories commonly used to predict disease outcomes—such as gender, race and ethnicity, and social class—have become contested terrain, and why some groups have more limited access to health care services than others. Juxtaposing first-person narratives with empirical and conceptual studies, this compelling collection draws on several disciplines, including cultural and medical anthropology, sociology, and the history of medicine.
The Social Medicine Reader, Second Edition:
Volume 3: Health Policy, Markets, and Medicine
Jonathan Oberlander, Larry R. Churchill, Sue E. Estroff, Gail E. Henderson, Nancy M. P. King, and Ronald P. Strauss
Over the past four decades the American health care system has witnessed dramatic changes in private health insurance, campaigns to enact national health insurance, and the rise (and perhaps fall) of managed care. Bringing together seventeen pieces new to this second edition of The Social Medicine Reader and four pieces from the first edition, Health Policy, Markets, and Medicine draws on a broad range of disciplinary perspectives—including political science, economics, history, and bioethics—to consider changes in health care and the future of U.S. health policy. Contributors analyze the historical and moral foundation of today’s policy debates, examine why health care spending is so hard to control in the United States, and explain the political dynamics of Medicare and Medicaid. Selections address the rise of managed care, its impact on patients and physicians, and the ethical implications of applying a business ethos to medical care; they also compare the U.S. health care system to the systems in European countries, Canada, and Japan. Additional readings probe contemporary policy issues, including the emergence of consumer-driven health care, efforts to move quality of care to the top of the policy agenda, and the implications of the aging of America for public policy.
The Political Life of Medicare
In recent years, bitter partisan disputes have erupted over Medicare reform. Democrats and Republicans have fiercely contested issues such as prescription drug coverage and how to finance Medicare to absorb the baby boomers. As Jonathan Oberlander demonstrates in The Political Life of Medicare, these developments herald the reopening of a historic debate over Medicare's fundamental purpose and structure. Revealing how Medicare politics and policies have developed since Medicare's enactment in 1965 and what the program's future holds, Oberlander's timely and accessible analysis will interest anyone concerned with American politics and public policy, health care politics, aging, and the welfare state.
Making It Crazy: An Ethnography of Psychiatric Clients in an American Community
Sue E. Estroff
Estroff describes a group of chronic psychiatric clients as they attempt life outside a mental hospital.