Showing 111 - 120 of 482 annotations tagged with the keyword "Medical Ethics"
Summary:In 1954, a United States Marshal (Leonardo DiCaprio) and his partner (Mark Ruffalo) take the ferry to Ashecliff Hospital, a forbidding asylum for the criminally insane located on Shutter Island. Their mission is to investigate the disappearance of an inmate who has apparently escaped without a trace. Under the supervision of the chief psychiatrist, Dr John Cawley (Ben Kingsley), they become increasingly entwined in a twisting tale of fear and suspicion.
This novel interweaves facts about the history of genetics with compelling fictional characters and plots in two connected stories. The primary story traces the life and work of the fictional Benedict Lambert, brilliant 20th Century geneticist, and an achondroplastic dwarf; his research is to discover the gene mutation which has caused his condition. He is also the great-great-great nephew of Gregor Mendel.
The life and genetic work of Gregor Mendel comprise the second story. Intersecting with Gregor Mendel's 19th Century scientific experiments to artificially fertilize pea plants is Lambert's affair with married librarian Jean Piercey. When Jean becomes pregnant, she decides on termination after learning from Benedict that there is "a fifty-fifty change of ending up like me . . . a second Benedict, another squat and crumpled creature betrayed by mutation and the courtly dance of chromosomes . . . " (180).
By the novel's end, Mendel's work has been published, and dismissed; Benedict Lambert has discovered the location of the gene mutation which causes achondroplastic dwarfism, publishes the results in Nature, and is asked to make a presentation on "the New Eugenics". Jean regrets the abortion, and wants Benedict's child, but a ?normal" one. In an attempt to help Jean in her quest, Benedict uses his genetic knowledge, his laboratory privileges, and his sperm without the knowledge or consent of Jean's husband.
In the lab with eight of Jean's fertilized embryos Lambert must decide: "Four of the embryos are proto-Benedicts, proto-dwarf; the other four are, for want of a better word normal. How should he choose?" The results of this scientific and personal act of fertilization are unexpected and tragic.
Summary:As Audrey Young describes her process of becoming a compassionate internist in a besieged public hospital, she simultaneously argues for turning the hospital's patient care and financial practices into a model for improving health care in America. Young, a compelling storyteller, first entered Seattle's Harborview Medical Center in 1996 as a third-year medical student on trauma surgery service. She completed a residency there in general internal medicine and stayed on as an attending for six more years. She stayed, she tells us, because she met physicians "committed to a vision of equality" who were "the sort of people I hoped to become" (xiii). She also "fell in love" with "the story of a unique place" (xiii). Young's stories of that often chaotic place, where ambulances regularly transport homeless, indigent, addicted, and mentally ill refugees from neighboring private hospitals, emphasizes the ways the Harborview staff manages to treat patients with dignity and to choose an ethic of hope in the face of dire circumstances.
This annotation is based upon the version presented at The Mint Theatre in New York City in 2010, translated and directed by Gus Kaikkonnen. It featured Thomas M. Hammond as Dr Knock and Patrick Husted as Dr Parpalaid, with Chris Mixon, Scott Barrow, and Patti Perkins in supporting roles.
A middle-aged but recently licensed physician, one Dr Knock, has arrived in rural France to take over a practice purchased from the genial old country doctor, Dr Paraplaid. Much to Dr Knock's surprise, he discovers that Dr Paraplaid has done very little over the past three decades, seeing only a few patients a week and enjoying much of the time playing pool, riding around in his jalopy, and admiring the countryside. Feeling slightly cheated, Dr Knock realizes that the practice he has purchased at some expense amounts to very little at all. He is, however, an ambitious man. He did not become a licensed physician in the eager flush of late adolescence but as a man of the world, or rather, a man of the entreprenurial modern world where opportunities are seized and technology is transformative.
Once Dr Paraplaid has gone, Dr Knock promptly sets about employing the town crier to advertise his practice so that the entire valley knows he is there. He meets up with the local school teacher and the pharmacist, enlisting them as allies. With everybody he encounters, he smilingly and then sharply insists that unlike Dr Paraplaid, he will not go by "Monsieur" but by "Doctor". And when he actually opens the office, he begins by offering free consultations. Of course, he always seems to find something wrong, elaborately explaining the aches, pains, and illnesses he discovers (or induces), but the free consultations, like free "samples" are designed to create grateful customers. Invariably, they learn that the cost of the treatment is commensurate with the exact maximum amount they could pay. And thus, Dr Knock takes a placid, lazy practice and builds up an expanding medical business.
In 2008, editor and physician Paul Gross launched a new online publication, "Pulse--voices from the heart of medicine" (published by the Department of Family and Social Medicine, Albert Einstein College of Medicine and Montefiore Medical Center). This anthology contains every poem and first-person narrative published during Pulse's first year, arranged in five sections corresponding to publication date and not to theme: Spring, Summer, Autumn, Winter, and Spring. Paul Gross, in his introduction, states "After more than a decade of practice as a family doctor, I came to appreciate that the science I'd learned in medical school, though powerful and useful, was also incomplete . . . . it contained much truth about illness and healing, but not the whole truth" (xvii). Like many other caregivers, Gross discovered "that writing and sharing my healthcare stories with others was therapeutic" (xviii). He looked to "Sun Magazine" as an example of how first person narratives, both prose and poems, could turn "hurts and triumphs into something potentially beautiful, funny or moving" (xviii).
The poems and prose that arrive every Friday online to Pulse's thousands of subscribers (and the selections in this anthology) are carefully screened by the editors according to these guidelines: the stories have to be first-person, and they have to be true, recounting the writer's own experience. Submissions are accepted from any person involved in healthcare. The language used must be "clear, simple language. No medical jargon. No arcane literary devices" (xx). Gross and his editors decided that Pulse would not be a medical journal nor a literary magazine--its purpose fell outside the perimeters of both genres--and so Pulse, and this anthology, offers work that is, in a refreshing and honest way, different from the slick or more polished poetry and prose that might be found elsewhere.
In reading this anthology from cover to cover, and so from season to season, I found that the poems and prose seemed to fall into several categories: Personal musings, in which authors relate healthcare experiences that engender intimate and revealing narratives about their own lives--among the best of these are "Well Baby Check," p.3; "Finding Innisfree," p. 31; "First Patient," p. 39; "Losing Tyrek," p. 45; "Carmen's Story," p. 62; and "Chemo? No Thanks," p. 106. Other pieces are commentaries on the other side of healthcare, the one that cries out for reform and affects both patients and caregivers. Among the best of these are "Redesigning the Practice of Medicine," p. 9; "A Brush with the Beast," p. 22; "Rx," p. 60; "Halloween Horrors," p. 69; and "Brain Cutting," p. 136.
Other pieces are humorous ("Aunt Helen Sees a Ghost," p. 6) or political ("My War Story," p. 11), and many poems and prose pieces speak of patient encounters or about being a patient, some more anecdotal, relating a specific incident that affected the author ("Once," p. 41) and others multi-layered, some relating medical student or intern experiences ("Jeannie," p. 48; "A View from Nepal," p. 87; "Ripped from the Headlights," p. 90; "Snowscape," p. 97; "First Night Call," p. 100; and "Wounded Messenger," p. 114.) The "category" I found most interesting and most unique are the selections I will call "confessions." These writings--demonstrating openess and bravery on the part of the authors--tell of regrets, mistakes, sorrows, wrong calls and other mishaps that occur, daily, in the practice of healthcare. In these, the most human face of caregiving is revealed. Although most of the pieces in this anthology contain elements of "confession," the most specifically revealing include "Mothers and Meaning," p. 14; "Physician's Exasperation," p. 44; "Confidential," p. 53; "My Patient, My Friend," p. 73; and "Apologies," p. 104.
Editor's note: Coincidentally, a recent relevant paper on confessional writing by physicians expounds further on this topic:"Bless Me Reader for I Have Sinned: physicians and confessional writing" by Delese Wear and Therese Jones (Perspectives in Biology and Medicine, Vo. 53, No.2, Spring 2010, pp. 215-30).
Summary:Some 40 years after a ceasefire that ended the Cylon wars, the 12 human colonies across the galaxy have been lulled into a state of calm complacence. This is abruptly interrupted by a Cylon attack that annihilates billions of humans, leaving only 50,000 survivors in a small fleet of ships, led by the one remaining ship from the Colonial Fleet, the Battlestar Galactica. Fleeing the Cylons, they set out to find the legendary 13th Colony: Earth.
First published in 1971 and subtitled, The Adventures of a Bad Catholic at a Time Near the End of the World, the novel is a satire of the limits of technology, the medicalization of the human spirit, and the trivializing tendencies of 20th century medical science. Dr. Tom More is an "impaired" psychiatrist: an alcoholic, a womanizer, and a half-hearted clinician. He develops the lapsometer, a kind of stethoscope of the human spirit with which he plans to cure humankind’s spiritual illnesses. Living daily with the contempt of his colleagues, he tries to prove himself and runs into all kinds of mischief, allowing the author to spoof the ills of medicine as it is practiced today.
Summary:This is an anthology of 32 pieces, many directly relating to war and its aftermath, or, in general, kinds of violence humans inflict upon each other and the ensuing suffering: hence the title, "echoes of war." The pieces include short fiction, essay, a dozen poems, and a photo collection. Since none are lengthy, this is a good reader to supplement other longer texts or to serve as an anthology for a reading group. A short essay, "Suggested Longer Readers," mentions some three dozen pivotal topics, including "homecoming" and "sense of identity."
The speaker in this short poem is a physician whose father's "castrated body" is "crooked in prostatic pain." From the family home in Tennessee, the dying man's wife provides daily phone reports to the son about her husband's deteriorating condition. The speaker's mind swirls with conflicting feelings: he thinks about "Dr. Death," whose efforts he has just come to understand; he thinks about the suffering experienced by his father and his mother's "terminal voice"; and he considers "how many of those little pain killers it might take."
Similarly, recollection of the Hippocratic vows intrudes to counsel against the kind of assistance his filial nature wants to provide. The internal debate about choices directs readers back to the title's imperative, "let's talk about it," suggesting, I believe, the need for social and professional discourse about quality of life, futility, and physician-assisted-suicide.
The title refers to a Veteran’s Administration hospital regulation concerning the withholding of full medical benefits if an ailment is not specifically related to military service. In an oftentimes comic battle between the forces of good--physicians and vulnerable patients--and those of evil--the administrators and their minions--the story has currency and direct appeal to viewers.
The Darth-Vader-like administrators are self-serving, inhumane bureaucrats with emotions that run the gamut "from A to B" (Dorothy Parker). Physicians, especially the character played by Ray Liotta, but also his dedicated colleagues, are imaginative and non-rule abiding in their central concerns: the patients. They listen to stories and sympathize; in addition, they turf, lie, steal, and do whatever is necessary to protect, serve, and treat their patients. When the government denies a heart bypass, for example, the docs schedule prostate surgery for the official record and do, instead, the needed heart surgery.
At times, it’s as if the Marx Brothers or the Keystone Cops have donned white coats to sneak around the hospital with patient-centered antics. In the absurd bureaucracy, viewers, perforce, must cheer enthusiastically for the merry band of renegade docs.