Includes bibliographical references (p. [259]-275) and index.
Contents:
Why doctor does not know best. The puzzling case of the broken arm -- Hernias, diets, and drugs -- Why physicians cannot know what will benefit patients -- Sacrificing patient benefit to protect patient rights -- Societal interests and duties to others -- The new, limited, twenty first century role for physicians as patient assistants -- Abandoning modern medical concepts : doctor's "orders" and hospital "discharge" -- Medicine can't "indicate" : so why do we talk that way? --"Treatments of choice" and "medical necessity" : who is fooling whom? -- Abandoning informed consent -- Why physicians get it wrong and the alternatives to consent : patient choice and deep value pairing -- The end of prescribing : why prescription writing is irrational -- The alternatives to prescribing -- Are fat people overweight? -- Beyond prettiness : death, disease, and being fat -- Universal but varied health insurance : only separate is equal -- Health insurance : the case for multiple lists -- Why hospice care should not be a part of ideal health care I : the history of the hospice -- Why hospice care should not be a part of ideal health care II : hospice in a postmodern era -- The new medicine and the new medical science. Randomized human experimentation : the modern dilemma -- Randomized human experimentation : a proposal for the new medicine -- Clinical practice guidelines and why they are wrong -- Outcomes research and how values sneak into finding of fact -- The consensus of medical experts and why it is wrong so often.
Summary:
Robert Veatch, one of the founding fathers of contemporary bioethics, sheds light on a fundamental change sweeping through the American health care system, a change that puts the patient in charge of treatment to an unprecedented extent. The change is in how we think about medical decision making. Whereas medicine's core idea was that medical decisions should be based on the hard facts of science, the province of the doctor, the "new medicine" contends that medical decisions impose value judgments. Since physicians are not trained to make value judgments, the pendulum has swung greatly toward the patient in making decisions about their treatment. Veatch shows how this has been true only for value loaded interventions (abortion, euthanasia, genetics) but is coming to be true for almost every routine procedure in medicine, and uses a range of examples to argue that this change is inevitable and a positive trend for patients.--From publisher description.
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