Showing 161 - 170 of 473 annotations tagged with the keyword "Medical Ethics"

Sicko

Moore, Michael

Last Updated: Jan-08-2008
Annotated by:
Duffin, Jacalyn

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

The movie opens with a shot of a young man stitching up a laceration in his own knee. Another describes how he had to select which of two severed fingers would be re-attached because he could not afford both operations. They are among the millions of Americans without health insurance. But, the narrator says, the movie is not for them; rather it is for the majority of U.S. citizens who do have medical insurance and believe themselves protected.

Through a series of riveting vignettes, for-profit health care is shown to tyrannize the well, ruin the ill, and destroy families. It also erodes the psychological and moral fiber of the people working in the industry. Excursions to England, Canada, France and Cuba are presented in a series of encounters with physicians and patients, none of whom believe that they would be better off in the United States. A French doctor opines that he earns an adequate salary for a good quality of life. Even those seated in a Canadian waiting room profess satisfaction with the care given and understanding about delays. When asked why anyone would accept to pay the expenses of others, an elderly golfer explains patiently that it is what we do for each other in a caring society. Ex-pat Americans gather at a bar to describe their positive experiences with foreign health and maternity care.

Interviews with emotionally distraught people who have worked in the insurance industry reveal the relentless pressure to deny coverage and its reward system that favors those who generate the biggest savings. Special attention is given to Dr. Linda Peeno who testified before Congress in 1996, confessing that she had harmed people for the economic benefit of the insurance industry.

Moore gathers up a group of people whose sorry dilemmas within the U.S. system have left them with serious health problems. He escorts them to Cuba where physicians and nurses are only too pleased to diagnose and treat their illnesses– for free. The movie ends with an exposé of the superior health care given prisoners at Guantanamo and Moore’s stunt at trying to bring the unhappy Americans there for treatment.

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Summary:

In a future society in which biological reproduction is restricted and humanoid robots ("Mechas") are routinely manufactured to supplement the economic and social needs of humans ("Orgas"), Dr. Hobby (William Hurt) creates a prototype child Mecha, David (Haley Joel Osment), who has "neuronal feedback," the ability to love, and "an inner world of metaphor, self-motivated reasoning," imagination, and dreams. David is given to Henry and Monica, a couple whose biological child Martin is incurably ill and cryopreserved, awaiting a future cure.

More specifically, David is created out of Hobby's own loss and given to aid Monica's mourning for Martin, whom she has been unable to "let go" of as dead. It is thus Monica (Frances O'Connor) who must make the decision to perform the "imprint protocol" that will make David love her. After she stops resisting the desire to love a child (of any kind) again and implements the protocol, Martin is unexpectedly cured and comes home.

The ensuing turmoil sends David, accompanied by a robot Teddy bear, out into a nightmare world of adult Mechas, comprised of both Rouge City, where functioning Mechas like Gigolo Joe (Jude Law) do their sex worker jobs and also the fugitive realm where unregistered, discarded Mechas try to find the spare parts they need to rebuild themselves and elude trappers who take them to reactionary "Flesh Fairs" where they are publicly destroyed as an expression of rage against artificial technologies.

Joe and David, both set up and betrayed by humans jealous of their superiority at performing human functions, join together on a quest to make David "real" and return him to Monica. The quest takes them to a partly submerged Manhattan and sends David and Teddy two thousand years into the future to resolve the dystopic narrative.

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Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Collection (Essays)

Summary:

Part of a series, "Letters to a Young . . . [fill in the career]," this collection of essays by pediatrician-author Perri Klass is addressed to her son Orlando during the recent period when he was applying to medical school. The essays follow a chronological sequence, beginning with the decision to apply to medical school, the first two years of medical school, learning how to examine and talk to patients, residency training, physicians as patients, making mistakes, grappling with the most fundamental human issues in medicine, and the mingling of professional work and life.

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Summary:

First published in 1991, and available in reprint edition, this is a compendium of selected artworks and excerpts of diverse medical and literary writings from pre-Hippocratic times to the end of the 20th C. Each chapter integrates selections from medical or scientific treatises, with commentaries written by historians, essays by physicians and writers, and prose and poetry by physicians and by patients. The 235 images in this book include illustrations from medical textbooks and manuscripts, as well as cartoons, sculptures, paintings, prints and sketches. The colour illustrations are stunning and copious, and provide a visual narrative that resonates with each chapter of the book.

The first part of the book, Traditional Medicine, includes chapters on Ancient, Medieval, Renaissance, and Enlightenment medicine. These serves as a preamble for the second part, Modern Medicine, which includes art, medicine and literature from the early 19th century to the end of the 20th century.

The chapter “From the Patient’s Illness to the Doctor’s Disease” illustrates the rise of public health and scientific research with excerpts from works by Edward Jenner, John Collins Warren, René Laënnec, and John Snow, together with experience of epidemic diseases described by writer Heinrich Heine in his essay on “Cholera in Paris”. The chapter on “Non-Western Healing Traditions” includes botanical research by Edward Ayensu, a short story by Lu Hsun and the writing and paintings of George Caitlin on North American Indian healing.

In the patient-focused chapter, “Patient Visions: The Literature of Illness,” are stories of sickness by Thomas DeQuincey, Leo Tolstoy, Giovanni Verga, Katherine Mansfield, André Malraux, and Robert Lowell. The chapter which follows, “Scientific Medicine: the Literature of Cure,” provides the medical counterpoint with personal correspondence by Freud, medical treatises by Wilhelm Roentgen and Louis Pasteur, an essay on surgical training by William Halsted, and an excerpt from George Bernard Shaw's play, Too True to Be Good, in which a microbe takes centre-stage.

There are chapters on “Medicine and Modern War,” which includes personal writing by nurses Florence Nightingale and Emily Parsons, and poems by Walt Whitman, and Emily Dickinson, and “Art of Medicine,” with works by Arthur Conan Doyle, Anne Sexton, James Farrell and W.P. Kinsella.

The final chapter, “The Continuing Quest for Knowledge and Control,” contains no medical treatises but rather ends with personal reflections by the writer Paul Monette on AIDS, and by physician-writers, John Stone, Sherwin B. Nuland, Lewis Thomas, Dannie Abse, and Richard Selzer.

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Annotated by:
Duffin, Jacalyn

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

The exquisite young artist, Angélique (Tautou) sends a rose to her lover, the cardiologist Loic Le Garrec (Le Bihan). She is planning a future with him; the only problem is that he is married. But he has promised to leave his wife. Angélique is little troubled that the couple are expecting a baby and when the pregnancy is lost following an accident, she believes the day will be soon.

Her medical student friend, David, worries that she is being used and is appalled by the accumulation of disappointments and slights that Angélique must endure. She falls apart, neglects herself and the home and exotic plants that she has been watching for friends, but when she hears that Loic has been accused of assault by a female patient, she is utterly disbelieving. The patient is found dead and the doctor falls under suspicion.

Rapid rewind, and the movie begins again with the rose, and by repeating a handful of earlier scenes, retells the same events from the perspective of the doctor. He has no idea who is the sender of the rose, and as the flowers, notes, and gifts accumulate he grows more distracted, even angry, and his wife is suspicious.

It emerges that Angélique and Loic have barely ever spoken to each other and that she actually volunteered for house-sitting next door, in order to be close to him. The accident that caused the miscarriage was Angélique’s attempt to kill his wife by running her down with a motor scooter. The patient who charged the doctor with assault was wrongly mistaken by him for the secret admirer; he struck her out of anger and fear. She presses charges against him and pursues him through the courts until she is murdered by Angélique.

But the doctor knows none of that. When Angélique attempts suicide with gas, he saves her life and she is all the more smitten. Gradually the doctor realizes her real identity and the police link her to the murder. She is sent to a psychiatric hospital.

Years pass. Loic and his wife have two beautiful children. Angélique is finally discharged with reassurance that she will be well as long as she takes her medicine. In the final scene, the caretaker moves a large cupboard to find all the pills that she had been prescribed over four years pasted to the wall in a larger-than-life portrait of Loic.

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Running with Scissors

Burroughs, Augusten

Last Updated: Sep-03-2007
Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

This memoir chronicles the pre-adolescent and adolescent years of the author, the son of an alcoholic, abusive mathematics professor father and a psychotic Anne Sexton-wannabe confessional poet mother. The only family member who does not abuse the boy in any way is estranged--an older brother with Asperger’s syndrome. Meanwhile, the amount of trauma to which young Burroughs is subjected boggles the mind. Just when one thinks it couldn’t get any worse, it does.

Burroughs, who loves bright, shiny, orderly things, also likes doctors--paragons of cleanliness, virtue and wealth. Unfortunately, his mother’s psychiatrist, Dr. Finch, described as a charismatic Santa Claus-look-alike, is unethical, bizarre and squalid. As Mrs. Burroughs becomes more and more dependent on Finch, she allows her son to be adopted into the crazy Finch household.

This family includes wife Agnes, who copes with her husband’s infidelity by sweeping madly; son Jeff, daughters Kate, Anne, Vickie, Hope and Natalie; grandson Poo; and adopted son, Neil Bookman, who is twenty years older than Burroughs and homosexual. When Burroughs is thirteen, and has told Bookman that he, too, is gay, Bookman forces the boy to have oral sex. They become lovers.

The Finches, meanwhile, exhibit their quirks and weird tendencies in multiple ways. "Bible-dipping" is popular to read the future, as is prophesying by examining Dr. Finch’s turds. A patient with agoraphobia, Joranne, lives in one of the rooms--in fact, she has not left the room in two years. Young Burroughs is allowed to smoke and drink. When Burroughs says he doesn’t want to return to school, Dr. Finch facilitates this desire by giving Burroughs alcohol and pills to fake a suicide gesture, then hospitalizes the boy.

Yet Burroughs manages to befriend a couple of the Finch daughters, and to survive his childhood. The book closes with his departure for New York City and with an epilogue outlining various people’s outcomes. Finch lost his license due to insurance fraud.

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Brute

Selzer, Richard

Last Updated: Aug-15-2007
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

In the Emergency Room at 2 AM, a doctor tries to suture a laceration on the forehead of "a huge black man," brought in by the police. The man groans and strains; he won't hold still. Finally, the doctor becomes so angry that he sutures the patient's earlobes to the mattress. Not only that, he leans over the man's face and grins: "It is the cruelest grin of my life." Then he sutures the man's wound.

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Annotated by:
Kennedy, Meegan

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The famed surgeon Douglas Stone flaunts his notorious affair with Lady Sannox, although his professional reputation begins to suffer. One night a mysterious Turk asks him to attend his wife, who has cut her lip on a poisoned dagger. The Turk insists that amputation offers the only hope of recovery. Anxious to pocket the proffered gold, and impatient to get to his mistress, Stone dismisses his professional misgivings. He excises the lower lip of the veiled, drugged woman--only to find that he was tricked into disfiguring Lady Sannox herself. Lord Sannox (disguised as the "Turk") thus gains his revenge, with his wife morally chastised (and forever after in seclusion), and Stone’s "great brain [thenceforth] about as valuable as a cap full of porridge."

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Collection (Essays)

Summary:

This collection of essays by surgeon-writer Atul Gawande (author of Complications: A Surgeon's Notes on an Imperfect Science --see annotation) is organized into three parts (Diligence, Doing Right, and Ingenuity) and includes an introduction, an afterword entitled "Suggestions for becoming a positive deviant," and reference notes. Each part is comprised of three to five essays, which illustrate, as Gawande explains in the introduction, facets of improving medical care - hence the title of the collection: Better: A Surgeon's Notes on Performance. In typical Gawande style, even the introduction contains tales of patients - a woman with pneumonia who would have fared far worse had the senior resident not paid close and particular attention to her well-being, and a surgical case delayed by an overcrowded operating room schedule. Such tales are interwoven with the exposition of themes and the detailing of the medical and historical contexts of the topic at hand.

The essays, though loosely grouped around the improvement theme, can easily be read as individual, isolated works. The concerns range widely both geographically (we travel to India and Iraq as well as roam across the United States) and topically. For instance, we learn about efforts to eradicate polio in rural south India and the dedicated people who devise and implement the program. Another essay, far flung from the plight of paralyzed children, is "The doctors of the death chamber," which explores the ethical, moral and practical aspects of potential physician involvement in the American system of capital punishment (from formulating an intravenous cocktail ‘guaranteed' to induce death to the actual administration of such drugs and pronouncement of death).

In sum, the topics of the eleven essays are: hand washing, eradicating polio, war casualty treatments, chaperones during physical examinations, medical malpractice, physician income, physicians and capital punishment, aggressive versus overly-aggressive medical treatment, the medicalization of birth, centers of excellence for cystic fibrosis treatment, and medical care in India. The afterword comprises five suggestions Gawande offers to medical students to transform themselves into physicians who make a difference, and by including this lecture in the book, what the reader can do to lead a worthy life.

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Annotated by:
Belling, Catherine

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

This Japanese horror story is set in a hospital in financial crisis, short of supplies and staff. We see various nurses and doctors struggling with their working conditions. A patient is injured falling out of bed, a nurse practices her IV technique on an unconscious burn patient, a demented woman wanders the hallways talking to apparitions she sees in mirrors. Two events set the central plot in motion: the burn patient dies because of a medication error and those present—Dr Akiba (Koichi Sato) who was responsible and Dr Uozumi (Masanobu Takashima) who was supervising, as well as the nurse who gave the lethal dose and her supervisor—decide to cover up the mistake, and a patient is brought to the ER suffering from a mysterious infection that is liquefying his internal organs.

Dr Akai (Shirô Sano), a senior physician, demands that Drs Akiba and Uozumi begin a study of the infected patient, despite their terror. The patient is never shown directly, but we see green ooze running from his bed. Akai argues that that discovering the pathogen causing this illness will raise money for the hospital, but the real incentive he offers is blackmail: he knows about the mistake and the cover-up.

As the night proceeds, all those involved in the error are infected, taking on zombie-like characteristics, behaving abnormally (a nurse attempts to transfuse her own blood into a corpse; a doctor tries to strangle a patient who has asked to have his pain relieved) and oozing green fluid before dying. With Dr Akiba, however, we begin to realize that the pathogen is not purely somatic. Dr Akai may in fact be the dead burn patient, the “green” ooze is red blood seen through the distorted perception of those haunted by guilt, and the title’s infection is the contagious fear felt by health care professionals who, for various reasons, are incapable of the infallible work of healing that is expected of them.

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