Showing 431 - 440 of 473 annotations tagged with the keyword "Medical Ethics"

The Sea and Poison

Endo, Shusako

Last Updated: Mar-21-1997
Annotated by:
Fefferman, Stanley

Primary Category: Literature / Fiction — Secondary Category: Literature / Fiction

Genre: Novel

Summary:

This story, set in a hospital in a Japan demoralized by Allied air-raids, concerns an intern, Dr. Suguro, who is coopted by an ambitious senior surgeon to participate in medical experiments involving vivisection of captured American airmen. The experiments are to determine how much lung tissue can be removed before the patient dies, how much saline solution, and how much air can be injected into the blood before death occurs. Ostensibly this knowledge will improve treatment of tuberculosis which is ravaging the country. The real motivation arises from the brutality of the military, from competition among hospital department heads, and from an atmosphere of nihilism in the face of almost certain defeat by the Allies.

Dr. Suguro's acquiescence humiliates him. Paralyzed by moral conflict into non-action in the operating room, he succumbs to deeper shame and humiliation. The novel begins many years after the event, when a narrator comes as a patient to Dr. Suguro's dilapidated clinic.

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The Sea and Poison

Endo, Shusako

Last Updated: Mar-21-1997
Annotated by:
Willms, Janice

Primary Category: Literature / Fiction — Secondary Category: Literature / Fiction

Genre: Novel

Summary:

In this short novel, published in the 1950’s by a popular Japanese fiction writer, the themes of cruelty, moral weakness, and contempt for human life in a medical school are portrayed. In a somewhat awkward series of narrations with flashbacks within flashbacks, the reader is introduced to the characters whose participation in wartime atrocities will be studied. Japan is suffering from the ravages near the end of the war. There is little food, daily bombing, and a general sense of futility.

The two surgical interns, Suguro and Toda, are the low men on a totem pole of power. Their aging chief is one of two contenders for the Dean’s position. He and his assistants devise methods of gaining attention for the promotion which include risky surgical procedures and, ultimately, vivisection experiments on American prisoners. The story line is carried by the acceleration of evil actions as the pressure for power increases. The motivations and internal deliberations of the two interns and one nurse whose characters are explored in some depth provide the human tensions.

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Armadale

Collins, Wilkie

Last Updated: Mar-07-1997
Annotated by:
Moore, Pamela

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Armadale is of interest for several reasons. First, the novel centers on issues of fate. Are our destinies determined, or can they be altered? The two heroes of the novel, Ozias Midwinter and Allan Armadale, are born under a curse. Midwinter's father murdered Allan Armadale's father. On his death bed, Midwinter's father warns that if these two sons ever meet, tragedy will occur. Midwinter learns the story and is uncertain whether to leave Allan or to work at changing their fate. Collins does not offer a solution, but provides plenty of opportunity for discussion.

Second, there is a doctor in the novel whose behavior is unethical to say the least. When the reader is first introduced to him, he is running a clandestine abortion clinic. When that operation is shut down by the police, he opens a private sanitarium. He privately confesses to being utterly uninterested in his patients' health. He only wants their money.

When the local ladies come to tour the facilities he espouses a system of liberal care, including dances, fine meals, and edifying concerts on Sunday evenings. However, the building is laid out with an intricate system of pipes that allow the doctor to keep his patients continually sedated. At the novel's end, the doctor helps plan a murder using those pipes.

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Summary:

A journalistic account of the CIA-funded experiments in "psychic-driving" of Dr. Ewen Cameron at Montreal's Allan Memorial Institute in the 1950's and early 1960's. Cameron investigated "treatment" for various forms of depression, consisting of high-dose electroshock (Page-Russell variant), heavy sedation, and the repetetive playing of patient's or the doctor's recorded voice.

Many patients did not respond; some were destroyed by the technique. Particularly moving is the story of Mary Morrow (Chapter 9), a physician-patient whose career was damaged by her experiences. Cameron held the most prominent positions in professional psychiatry; he died unscathed by his questionable research and in pursuit of yet another goal, a mountain peak.

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The Joys of Motherhood

Emecheta, Buchi

Last Updated: Feb-18-1997

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Nnu Ego is the daughter of a great Nigerian chief. She is expected to have many sons. With her first husband who beats her, she has no children. She leaves him and is married to a man who works on the coast in a British colony. Her life there is miserable. She and her husband slowly lose their village values and begin a daily battle for food and money.

Nnu Ego nevertheless becomes pregnant. Her infant son dies suddenly and she nearly goes mad. She recovers and produces many children, including two sons. Her eldest son goes to school in America, marries a white woman, and rarely contacts his mother. Certainly, he does not financially support her as village ethics demand. Her younger son follows in his brother's footsteps. Nnu Ego is considered a success in her village, but she dies alone. Her eldest son returns to Nigeria and pays for a big funeral in order to prove what a good son he is.

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Arrowsmith

Lewis, Sinclair

Last Updated: Jan-31-1997
Annotated by:
Aull, Felice

Primary Category: Literature / Fiction — Secondary Category: Literature / Fiction

Genre: Novel

Summary:

This novel was inspirational for several generations of pre-medical and medical students. It follows the hero, Martin Arrowsmith, from his days as a medical student through the vicissitudes of his medical/scientific career. There is much agonizing along the way concerning career and life decisions. While detailing Martin’s pursuit of the noble ideals of medical research for the benefit of mankind and of selfless devotion to the care of patients, Lewis throws many less noble temptations and self-deceptions in Martin’s path. The attractions of financial security, recognition, even wealth and power distract Arrowsmith from his original plan to follow in the footsteps of his first mentor, Max Gottlieb, a brilliant but abrasive bacteriologist.

In the course of the novel Lewis describes many aspects of medical training, medical practice, scientific research, scientific fraud, medical ethics, public health, and of personal/professional conflicts that are still relevant today. Professional jealousy, institutional pressures, greed, stupidity, and negligence are all satirically depicted, and Martin himself is exasperatingly self-involved. But there is also tireless dedication, and respect for the scientific method and intellectual honesty.

Martin’s wife, Leora, is the steadying, sensible, self-abnegating anchor of his life. In today’s Western culture it is difficult to imagine such a marital relationship between two professionals (she is a nurse). When Leora dies in the tropics, of the plague that Martin is there to study, he seems to lose all sense of himself and of his principles. The novel comes full circle at the end as Arrowsmith gives up his wealthy second wife and the high-powered, high-paying directorship of a research institute to go back to hands-on laboratory research.

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

Dr. Cassell examines the social and cultural forces that encourage the practice and teaching of a medicine that is governed by the disease theory. This theory discounts the impact of illness on the patient and ignores the suffering that the patient is experiencing. Cassell does not debunk science and technology, rather he encompasses them within the moral enterprise of medicine as tools for helping patients.

The ability to provide compassionate attention to the patient as individual (i.e., with unique values, life experiences, family interactions, etc.), trustworthiness and self-discipline are required characteristics of a "good physician." Cassell illustrates and personalizes the philosophical shift towards focusing on the sick person with stories and anecdotes.

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Hard Cash

Reade, Charles

Last Updated: Jan-29-1997
Annotated by:
Moore, Pamela

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Reade was known for writing "novels with a cause." Here, as in several other of his novels, his cause is the deplorable condition of mental hospitals in the early to mid-nineteenth century. Until late in the century, many considered the mentally ill untreatable. Hospitals were more like prisons than places for treatment. Admission policies were also fairly lax. Reade records a common fear that healthy people would be incarcerated.

In Hard Cash, a father incarcerates his son in order to cover up a crime. The doctors who admit him have a kickback scheme worked out with the hospital--they get money for each patient admitted. Once in the hospital, the hero tries to prove his sanity but finds it impossible to battle against doctors who refuse to look past the diagnosis that caused his admission to his actual mental condition. He also must negotiate with the head of the hospital, a woman who is madly in love with him and refuses to allow him out of her sight.

He cannot prove his sanity and only escapes when there is a fire in the asylum. There is one "good" doctor in the story who refuses to bleed patients, deny them food, or admit the sane to mental hospitals. The other doctors think him a quack, but he saves several lives.

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Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Poem

Summary:

This 14 line poem deals with a physician's compassion for a hopelessly ill patient ("An apparatus not for me to mend--") and his participation in active euthanasia. The patient, Annandale, was "a wreck . . . and I was there." The narrator asks the reader to view himself or herself "as I was, on the spot-- / with a slight kind of engine." (This "engine" is a hypodermic needle.) He concludes, "You wouldn't hang me? I thought not."

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The Imp of the Perverse

Poe, Edgar Allan

Last Updated: Jan-29-1997
Annotated by:
Moore, Pamela

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The story begins with a philosophical discussion about how science (especially phrenology) understands human beings. It is the narrator's contention that science develops a priori. One first decides on the basic needs of humankind, then ascribes to certain organs the role of satisfying those needs. The narrator thinks this is backwards: "It would have been wiser, it would have been safer to classify . . . upon the basis of what man usually or occasionally did, and was always occasionally doing, rather than upon the basis of what we took for granted the Diety intended him to do."

One major trait scientists have overlooked is perversity. Men often do things for no better reason than that it will hurt themselves or others. The narrator then tells how he murdered a man and lived contentedly with the knowledge for many years until he was suddenly, perversely compelled to confess.

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