Showing 281 - 290 of 469 annotations tagged with the keyword "Medical Ethics"
A down-and-out attorney, who has become somewhat obsessed with the case of a severely impaired woman who had suffered brain damage during the course of a surgical procedure, presses forward to prove medical malpractice. In the course of developing the case he is opposed by the Bishop of the diocese which owns the hospital in question; one of the most powerful law firms in the city; and, acting as "spy" for the defense team, a beautiful woman lawyer.
Galvin, the protagonist, is encouraged to continue his pursuit of justice by an honest former partner and his own belief in the patient's childrens' right to a settlement. Galvin wins his case by proving that the medical records have been altered.
Set sometime in the near future, Cast of Shadows has as its protagonist Davis Moore, a successful private practice physician specializing in cloning human babies for infertile couples. Early in the book, Anna Kat, his high school senior daughter, is murdered and raped. (For a while a likely suspect is Mickey the Gerund, a right wing extremist member of the Hands of God with a fascinating grammatical moniker never explained, who shoots cloning physicians, including Dr. Moore, in the abdomen, a short time before his daughter, Anna Kat, is brutally killed. However, Mickey is only a shadow of a suspect and quickly becomes supplanted by another much more likely villain. Mickey goes on to kill, by various methods, dozens of cloning physicians and staff by book's end.)
After a year of unsuccessful detective work, the local police return Anna Kat's belongings, including a plastic vial with the suspected murderer-rapist's semen. In an act never fully explored by Dr. Moore or the author, an otherwise rational and ethical physician surreptitiously uses the suspect's semen to fertilize a married woman patient.
The offspring, a clone of the suspected killer-rapist, is Justin, who becomes a formidable presence in the book. He is very intelligent--at his psychologist's advice, his parents provide him at an early age with advanced reading materials like Plato (hence one of the allusions to shadows, i.e., Plato's cave, in the book's title and referenced directly on page 118 and indirectly on page 208) and other philosophers. By the time he is a senior in high school, Justin has become a dominant player in the affairs of Dr. Moore; Sally Barwick, a private investigator-turned journalist; and the suspected killer-rapist--his origin of the species as it were.
This book has a number of subplots all of which radiate from the initial cloning and the various members of the extended family and professional staff involved in it, some knowingly, most not. There are narrative threads involving the suspected murderer rapist-now-prominent attorney, Sam Coyne; the triangle of Dr. Moore and Jackie, his alcoholic wife, and Joan, his attractive pediatrician associate; Mickey the Gerund's various murderous and obsessional religious activities and reflections; Justin's life in school and involvement with Sally Barwick's investigation of a serial killer called The Wicker Man; and, most especially, the development of Shadow World, a computer game and a virtual replica of the real world--the world as Justin, Sally, Sam Coyne, and Dr. Davis Moore know it.
Since this is a thriller, it would be inappropriate to divulge more of the plot, which is intricate, often a little far-fetched but always engaging, highly readable and more labyrinthine than most medical thrillers.
In 1950 London, lower middle-class (but upper middle- aged) Vera Drake (Imelda Staunton) devotes herself to family and "helping" others. With empathic cheeriness, she visits shut-ins, provides tea for the bedridden, feeds lonely men, and "brings on their bleeding" for girls in trouble. She also tends her cantankerous, ailing mother, who has never revealed the identity of Vera’s father.
The men in Vera’s life are bruised and confused by end of the war. Exuding affection, she cooks, irons, sews, and listens to their litanies of loss and derring-do. Her son, Sid, is an extroverted clothing salesman and her dowdy daughter, Ethel (Alex Kelly), is a pathologically shy factory-worker; neither seems adequate for the task of living alone. But Vera and her husband, Stan (Phil Davis), are happy in each other, their offspring, and their modest existence.
Only the friend, Nellie, knows of the help for young girls. She extracts a secret two-guinea fee for advising the girl, but Vera receives not a penny. Over the years, the two women have solved problems for mothers with too many children, mothers with no man, and mothers who were raped. They also safely abort insouciant party girls who are blas?about men, sex, and consequences.
But a young girl falls seriously ill following an abortion and is sent to hospital. Under pressure from police, the girl’s mother divulges Vera’s name. The police barge in to arrest her just as the Drake family celebrates Ethel’s engagement to one of the lonely men, Reg (Eddie Marsan).
The criminal charges come as a complete surprise to the family. Sid seethes with anger and disbelief, but Stan’s implicit faith in his wife brings him and the others to support her through the long trial. The judge hands her a stiff thirty-month sentence intended "as a deterrent." But in prison, Vera meets two other abortionists who tell her that she is lucky: both are serving much longer, second sentences, because their "girls" had died.
Summary:This book contains six medical case studies in which hope, or lack of it, played a role in the outcome. Five stories are of Groopman's cancer patients, the sixth the story of his own recovery from severe chronic lower back pain. The book concludes with an account of Groopman's search for scientific answers to the questions that inspired the book: How is the cognitive-emotional complex of hope formed in the mind? How might that complex affect the chemistry of the brain? And how might that, in turn, affect the physiology of the body in a way that would be relevant to healing?
Film clips of Cary Grant as the consummate anatomy professor in 0100 (see this database) are interspersed with comments from contemporary gross anatomy students, two medical school faculty intimately connected with dissection and the body donation tradition, and a live body donor. In what ways "yes" and "no" could both be proper responses to the statement, "A cadaver in the classroom is not a dead human being" is the key premise, beautifully presented in the cut-aways, organization, and editing of this piece.
The structure of the film is an as-if dialogue between young dissectors and soon-to-be cadaver (the body donor). Interviews heighten and explore the relationship between the living and the dead--and not just medical students and body donors. The medical students do not speak directly with the future donor, though we see him shaking hands with them, visiting (and speculating on) the spot where his remains will eventually be deposited. The video concludes with a moving annual ritual, the disposition of body donors' cremated remains at sea.
The surgeon-narrator and his team of assistants (the anesthesiologist, scrub nurse, circulating nurse, surgical resident, and medical student) perform a difficult operation during the night. The patient has an infiltrating cancer of the stomach (linitis plastica) that has eroded his aorta. Because of uncontrollable bleeding, the operation (an exploratory laparotomy with attempted repair of a malignant aorto-gastric fistula) is as doomed as the patient himself.
The surgeon soon comprehends the hopelessness of the procedure as well as the patient's terminal condition. He turns off the oxygen from the gas tank and stops the patient's blood transfusion. Minutes later, the man dies. Blood is all over everything. The doctor must now deliver the bad news to the man's family. He has the medical student tag along.
Members of the patient's family are upset and some are even out of control so he dispenses tranquilizers to them. The surgeon returns to the operating room (OR) and even now finds blood everywhere. The OR team is still working. The doctor showers and then goes back to the OR once more. The room is now dark and empty but clean. The surgeon imagines the dead man's body with a row of abdominal stitches that he likens to hieroglyphics. The unsuccessful operation and the surgeon's actions are thus both concealed and unforgettable.
Kirk, a man in his 50s with highly metastasized kidney cancer, presents himself to Dr. Groopman after having been turned away as a helpless case by several respected cancer clinics. He tells Groopman that he is a risk-taking venture capitalist and is willing to take any medical risk on the chance that it will save him. After pondering the ethics of the situation and the nature of informed consent under such conditions, Groopman agrees to treat Kirk. He proceeds to devise a highly risky (and untried) combination of chemotherapeutic agents. The course of treatment is excruciatingly difficult, but the experiment succeeds, and Kirk's cancer goes into complete remission.
Kirk calls it magic, a miracle, and the hospital interns call it a "fascinoma," a case defying normal expectations. Groopman releases Kirk to home and weekly checkups with a local internist, but in doing so he notices that Kirk's mood has mysteriously changed. He has lost the "piss and vinegar" of their earlier contact. Kirk continues to improve physically, traveling and playing golf and even tennis, but Kirk's wife soon reports that Kirk has stopped reading the newspapers he used to devour, which now collect in their driveway.
Several months later some physical symptoms return, and Kirk's cancer is back. A month later he is dead. In talks with Kirk near the end, Groopman discovers that Kirk's brush with death had brought with it a new and sharply negative view of himself as selfish and disconnected from the world and other people. Suddenly all his financial success seemed to him "pointless," and, since his life contained nothing else, it seemed to him a waste, and he felt it was too late to live it over. What Kirk ironically calls "my great epiphany" seems to have undone his doctor's "magic."
It is 1905, and a young doctor just out of internship in Chicago has decided to head for the southwest to seek his fortune. He finds himself on a slow train in southern New Mexico, sitting across from a Sister of Mercy "in her black robes, skirts and sleeves, and heavy starch." When the train stops, the doctor inquires about a group of men huddled on the platform. They surround a severely ill Mexican worker, who turns out to have appendicitis. The doctor insists that only an immediate operation will save his life, but the Mexicans are violently opposed to surgery. Eventually, the doctor enlists the nun’s help to persuade them.
In the blistering heat, they carry the man to a shed where the doctor performs an appendectomy with instruments in his black bag, including morphine and chloroform. For the next 24 hours, he and the nun watch over the man, and then carry him to the nearest town on the next train. He survives, which is good because otherwise the Mexicans have threatened to kill the doctor. The nun, who throughout has been cool toward the doctor because of his use of "rough" language, proceeds on her way to Texas.
Birth Sounds includes 45 short tales of labor and delivery, ranging through a wide swath of the human comedy, but always maintaining focus on the very first scene. In most of these stories, it isn't the delivery that provides the drama, but rather the people. Take the first story, for example. In "Faceless" a Vietnamese husband cautions the obstetrician-narrator, "In our country no man will examine a woman in such an intimate way." The obstetrician never sees the patient's face, which she has covered with a towel. After the delivery, he examines her and speaks carefully, not sure that she understands English. However, from beneath the towel, she thanks him in a perfect American Southern accent. A neat surprise!
In "The Little Devil" (p. 6) a 38-year-old member of a satanic cult announces that she intends to kill the baby if it is a boy. She has been directed to do so by her satanic mentor. When, amid a panoply of lit candles and inverted crucifixes she delivers a boy, the resident contacts the sheriff's office, where the mother's intentions are already known. Sure enough, the SWAT team storms the delivery room and takes the baby.
In "Red Bag" (p. 31) the narrator is serving as a medical expert in a murder trial. The defendant had arrived at the hospital hemorrhaging after delivering a baby at home, evidently into the toilet bowl. The baby had died of head injury. The obstetrician-narrator turns out to be more supportive of the woman and less compliant than the prosecutor had expected; but afterward the doctor receives his financial reward--a check from the state for a full $7.00!
In "Resilience" (p. 259) a woman with a near-term pregnancy asks the obstetrician to examine her breast, which has suddenly developed a red lump. He takes one look and immediately experiences a flashback to another young woman he cared for who had developed breast cancer during pregnancy and died of metastatic disease about a year later. Sure enough, the current patient also has cancer. But in this case the patient delivers, receives treatment, and recovers, apparently cured of her cancer.
The House of God is a chronicle of Roy Basch's internship year at a prestigious Boston teaching hospital, also known as The House of God but clearly modeled after the Harvard-affiliated Beth Israel Hospital. Cycling through various medical disciplines, Roy and his peers learn medicine from the eccentric, irreverent, yet oddly compassionate Fat Man, whose 13 Laws of the House of God cynically summarize the harrowing and often demeaning hospital practices and rituals reflected in both the doctor-patient relationship and in the residency experience itself.