Showing 271 - 280 of 477 annotations tagged with the keyword "Medical Ethics"

Paris Requiem

Appignanesi, Lisa

Last Updated: May-17-2006
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

James Norton travels from Boston to Paris at his domineering mother's urging to bring home his fragile sister, Ellie, and their journalist brother, Rafael. He discovers Rafael devastated by the death of his Jewish lover, Olympe. Suicide, accident, or murder? Ellie is confined to a wheelchair owing to an unexplained paralysis. James is drawn into finding solutions to both problems and his investigations lead him to seedy brothels, the bureau of a hypnotist, the morgue of aspiring neurologists, and the wards of la Salpetrière, the famous neuropsychiatric hospital for women. The autopsy reveals that Olympe had been pregnant and the questions about her death multiply. The exoneration and return to France of Dreyfus plays as a backdrop.

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Meridian

Walker, Alice

Last Updated: May-15-2006

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Meridian is set in the American South during the 1960s and early '70s. The heroine, Meridian, is a black woman from a southern town. She marries, has a child, gets a divorce, sends her child away, and ends up working in a voters' registration campaign, encouraging African-Americans to register. Meridian is different from her co-workers in that she interacts with people as individuals, rather than by stereotyping them. For example, while others lecture black families about the importance of voting, Meridian sits and talks with them, trying to address their basic needs of food, heat, and affection.

As years pass, her co-workers quit and move into comfortable houses. She moves deeper south, living in whatever housing the community can afford to give in exchange for her constant work on their behalf. Frequently, after staging a rally or other event, Meridian develops partial paralysis. She grows more and more ill. A halo-like light surrounds her head as she thinks of the history of her people and of her role in that history. She ultimately heals herself and moves to the next small town.

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Annotated by:
Sirridge, Marjorie

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

This made-for cable film is based on the real-life story of Dr. Gisella Perl (Christine Lahti) as told in her autobiographical book, I Was a Doctor at Auschwitz. Originally published in 1948 and reprinted in 1997, the book is hard to find now. The film tells how Dr. Perl, a Jewish Hungarian gynecologist, is imprisoned and forced to be a camp doctor in Auschwitz during World War II.

Dr, Perl lost her parents, husband, and son during the war years. She had to relive her horrifying experiences and difficult moral choices as she faced an immigration panel in the U.S. in order to get her American citizenship after the war. Accused of collaborating with the Nazis, she was eventually exonerated and practiced in New York, later immigrating to Israel where she did important work. There were many other talented women who also fought to live but failed in their quests and Dr. Perl tells of the spirits of these women also.

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Change

Massad, Stewart

Last Updated: May-08-2006

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The narrator is an aging, male gynecologist who works in a small North Carolina town. The National Health Service sends a young doctor, Rachel, to work in the clinic. From Boston, she is unused to the town's racial politics. She learns slowly to understand the motivations and concerns of her patients. As she campaigns for condom distribution, she ends up insulting the white men who run the town by calling them racists.

The narrator protests that they have power in the town only because no blacks ever run for office and that their policies are meant to distribute wealth evenly. He encourages Rachel to be more gentle and womanly. She will get her way more easily if she smiles. But Rachel eventually turns her back on the narrator, too, when in order to get a violent black man out of the clinic's lobby he calls the man "boy" and threatens to call the police. Rachel moves in with a black man. The town has revenge when a hit and run driver kills her lover and Rachel is hounded out of town.

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An Enemy of the People

Ibsen, Henrik

Last Updated: May-02-2006
Annotated by:
Woodcock, John

Primary Category: Literature / Plays

Genre: Play

Summary:

Dr. Thomas Stockmann, a public-minded doctor in a small town famous for its public baths, discovers that the water supply for the baths is contaminated and has probably been the cause of some illness among the tourists who are the town's economic lifeblood. In his effort to clean up the water supply, Dr. Stockmann runs into political cowards, sold-out journalists, shortsighted armchair economists, and a benighted citizenry. His own principled idealism exacerbates the conflict. The well-meaning doctor is publicly labeled an enemy of the people, and he and his family are all but driven out of the town he was trying to save.

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Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

This is an ambitious and far-ranging book, the result of years of thinking, teaching, and working with patients. An internist at the College of Physicians and Surgeons at Columbia University, Charon sees a wide range of patients in an urban setting. Also a Ph.D. in English literature, Charon has devised a "Parallel Chart" and other means for caregivers to write personally about the dynamics between healer and patient, to read texts--narratives in particular--and, as a result, to listen better to patients, thus improving the delivery of medical care.

Charon defines narrative medicine as "medicine practiced with these skills of recognizing, absorbing, interpreting, and being moved by the stories of illness" (4). She calls this a "new frame" for medicine, believing that it can improve many of the defects of our current means of providing (or not) medical care. Caregivers who possess "narrative competence" are able to bridge the "divides" of their relation to mortality, the contexts of illness, beliefs about disease causality, and emotions of shame, blame, and fear.

Charon finds that medical care and literature share five narrative features; she argues that careful reading of narratives builds skills that improve medical care, including intersubjectivity between caregiver and patient, and ethicality. Beyond the theory, there are powerful and persuasive examples of interactions between caregiver and patient, many from Charon's own practice. A mother of a sick daughter experiences stress that makes her ill; when she sees a narrative connection, she begins to heal.

Charon sees wider applications. As caregivers understand better concepts of attention, representation, and affiliation, they become more ethical, more community minded, and better healers to their patients. Patient interviews will be different: instead of following a grid of questions, physicians will converse with patients in an open-ended way. What is most important will emerge and emerge in ways that are most beneficial to the patient. Yes, this method will take more time but it will be more efficient in the long run. Bioethics, Charon argues, has been limited by legal approaches and philosophical principles. For her, narrative bioethics offers more human values in how people feel, experience reality, and relate to each other. Finally, there are implications for social justice: why are the poor underserved in this country and in many others?

One of the most exciting and radical formulations comes late in the book: ". . . practitioners, be they health care professionals to begin with or not, must be prepared to offer the self as a therapeutic instrument" (p. 215). This notion links up fruitfully with concepts of energy medicine (v1377v), therapeutic touch (Tiffany Field), and intentionality (Wayne W. Dyer).

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Health and Happiness

Johnson, Diane

Last Updated: Apr-24-2006
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

The site of the multiple stories interwoven in this novel is a teaching hospital in San Francisco. One of the featured characters is a young single mother who comes in with a swollen arm and finds herself in more medical trouble than she anticipated. She suffers a mild stroke after debatable treatment. Two doctors attend her, but differ markedly in their ideas of how to treat her and their human responses to her. One ends up having a brief affair with her that changes his life.

In addition to these there are stories of a comatose young man and the family that refuses to believe he will not awaken (he does); a volunteer coordinator who observes the politics of hospital life from a privileged margin, and sundry staff people who represent alternative points of view. The single mother recovers, but only after a stay in the hospital has convinced her she may not yet be too old to go to medical school to find a life not in marrying a doctor, but in being one.

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Summary:

Born in 1728 the tenth child in a struggling Scottish farm family, John Hunter was a wayward and unteachable child who spent most of his time outdoors. At the age of 20, with no prospects and having lost his father and 6 siblings, he wrote for help to his older brother William, who was practicing midwifery in London and had just opened England's first anatomy school, one featuring the revolutionary opportunity for students to dissect their own cadavers.

John rode the 400 miles to London on horseback, apprenticed with great success under William, learned dissection, then surgery, and went on to become a supremely gifted anatomist and surgeon, one whose brilliant and tireless experimentation broke with ancient and outmoded medical traditions and established the foundation for modern science-based surgery. (When John arrived in London, the city's Company of Barber-Surgeons had only just dissolved to allow surgeons to organize themselves independently of barbers.)

One of his most important activities in working for his brother--and which continued when he made his own way--was the procuring of cadavers, which because of the customs of the time involved him intimately in the grisly business of grave-robbing.

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Summary:

Shannon Moffett, a medical student at Stanford University School of Medicine, became fascinated with the brain during her anatomy and neurobiology courses. She set off across the country to interview people--scientists, doctors, patients, ethicists, and religious leaders--who devote their careers trying to understand the brain and cognition. With infectious enthusiasm and energy, Moffett brings the reader to meet these dedicated people, their work, their theories and their lives.

The book contains eight chapters and hence eight mini-biographies: 1) neurosurgeon Roberta Glick, 2) cognitive neuroscientist and brain imagist John Gabrieli, 3) Francis Crick (of DNA double helix fame) and Christof Koch--scientists studying consciousness, 4) sleep researcher Robert Stickgold, 5) Judy Castelli who has dissociative identity disorder (multiple personality disorder), 6) philosopher Daniel Dennett, 7) neuroethicist Judy Illes, and 8) Zen monk Norman Fischer.

Separating the chapters are "interludes" that map neural and brain development from conception to death. The book has a reference list for each chapter and a complete index, as well as a web resource (www.shannonmoffett.com) to which the reader is directed for graphics.

The writing is compelling, direct, fresh and insightful. For example, in "Touching the Brain," we follow the exhausting lifestyle of an academic neurosurgeon who works at Cook County Hospital in Chicago as she performs surgery, teaches, attends services at a temple, drives her car, takes care of her family including two young children, rounds on patients, hosts a potluck dinner, and simultaneously discusses her reading, travel and spirituality.

Moffett aptly describes Glick with her "waist-length red hair, ... beaten-metal earrings dangling almost to her shoulders and a saffron batik dress" as someone you'd "expect to find reading storybooks to kindergartners in a public library" (8). In fact, it is Moffett's eye for accessible detail that makes not only the people, but also neuroscience come alive. Artfully woven into the text are lessons on the history of brain research and current understanding (and questions) about the brain, its meaning and function.

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Maimonides

Nuland, Sherwin

Last Updated: Mar-29-2006
Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Biography

Summary:

This concise and well-written biography is meant to be, as Sherwin Nuland tells us, "a guide for the perplexed," for those who may recognize the name of Maimonides and his historical importance to Jewish religion and culture, or who may even have read some of his works, but have no knowledge of the man behind the name. The story begins, as it should, in Medieval Spain with its vibrant Judaeo-Islamic culture, in which the historical relationship between Judaism and medicine developed and later expanded throughout the European and Islamic worlds. Though they were outsiders in both civilizations, Jewish physicians became the most sought after healers in the Christian and Muslim worlds.

Moses son of Maimon (also known as Maimonides and the Rambam, 1138-1204) was born in Cordoba, the cultural and political center of Muslim Spain. He and his family had to flee Cordoba to avoid persecution in 1148. They wandered through Spain until 1160, when they settled in Fez, Morocco. Again fleeing from persecution, Maimonides moved to Fustat, Egypt, when he was 30 years old and remained there for the rest of his life. During these early years, the young rabbi wrote numerous biblical commentaries, culminating in the Mishneh Torah, his great code of Jewish law. Later, he attempted to reconcile faith with reason in another great work, The Guide for the Perplexed, completed in 1190.

Maimonides's specifically medical work is difficult to characterize and evaluate. The traditional historical assessment is that he was "unique in his time in the theory and practice of medicine." Essentially, he practiced Galenic medicine, as transmitted and developed in the flourishing Islamic tradition. We don't know how he acquired his medical knowledge, but by the time he reached Fustat, Maimonides was acknowledged to be a leading physician and in 1190 he was appointed personal physician to the vizier of Egypt. Late in life, Maimonides wrote a number of medical treatises, most importantly his Medical Aphorisms, which presents a coherent, well-organized, and practical medical system based on Galen and Aristotle.

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