Taming The Beloved Beast

Technological innovation is deeply woven into the fabric of American culture, and is no less a basic feature of American health care. Medical technology saves lives and relieves suffering, and is enormously popular with the public, profitable for doctors, and a source of great wealth for industry. Yet its costs are rising at a dangerously unsustainable rate. The control of technology costs poses a terrible ethical and policy dilemma. How can we deny people what they may need to live and flourish? Yet is it not also harmful to let rising costs strangle our health care system, eventually harming everyone? In Taming the Beloved Beast, esteemed medical ethicist Daniel Callahan confronts this dilemma head-on. He argues that we can't escape it by organizational changes alone. Nothing less than a fundamental transformation of our thinking about health care is needed to achieve lasting and economically sustainable reform. The technology bubble, he contends, is beginning to burst. Callahan weighs the ethical arguments for and against limiting the use of medical technologies, and he argues that reining in health care costs requires us to change entrenched values about progress and technological innovation. Taming the Beloved Beast shows that the cost crisis is as great as that of the uninsured. Only a government-regulated universal health care system can offer the hope of managing technology and making it affordable for all.

Summoned like a serving girl to the king, Laura Cambridge was hired as nanny to Richard Blackthorne’s secret child. Rumors about this hulking recluse didn’t daunt Laura—her beauty-queen past had taught her the inner person didn’t always match the facade. But Richard’s heart was as painfully scarred as his chiseled features.... To Richard, lovely Laura was like candy dangled in front of a baby—he was offered the sweet, but denied the taste. Yet sometimes grizzly bears enjoyed a taste of honey...and in fiction the disfigured Mr. Rochester won the love of Jane Eyre. So Richard dared to woo his green-eyed goddess, gambling that—like Jane—Laura would one day declare, “Reader, I married him.”

“Eloisa James’s writing is absolutely exquisite.” —New York Times bestselling author Teresa Medeiros “Nothing gets me to a bookstore faster than a new novel by Eloisa James.” —New York Times bestselling author Julia Quinn A wonderful spin on a much-beloved fairy tale, Eloisa James’s When Beauty Tamed the Beast is heart-soaring and fun historical romance at its finest. No wonder People magazine raves about her books, saying, “Romance writing does not get much better than this.” Eloisa’s delightful take on Beauty and the Beast unfolds in Regency England, where a beastly, bad-tempered Earl matches wits with a brazen beauty who has vowed to make the handsome grump fall in love with her in two short weeks.

Most of us want and expect medicine’s miracles to extend our lives. In today’s aging society, however, the line between life-giving therapies and too much treatment is hard to see—it’s being obscured by a perfect storm created by the pharmaceutical and biomedical industries, along with insurance companies. In Ordinary Medicine Sharon R. Kaufman investigates what drives that storm’s “more is better” approach to medicine: a nearly invisible chain of social, economic, and bureaucratic forces that has made once-extraordinary treatments seem ordinary, necessary, and desirable. Since 2002 Kaufman has listened to hundreds of older patients, their physicians and family members express their hopes, fears, and reasoning as they faced the line between enough and too much intervention. Their stories anchor Ordinary Medicine. Today’s medicine, Kaufman contends, shapes nearly every American’s experience of growing older, and ultimately medicine is undermining its own ability to function as a social good. Kaufman’s careful mapping of the sources of our health care dilemmas should make it far easier to rethink and renew medicine’s goals.

One of the founding fathers of bioethics describes the development of the field and his thinking on some of the crucial issues of our time. Daniel Callahan helped invent the field of bioethics more than forty years ago when he decided to use his training in philosophy to grapple with ethical problems in biology and medicine. Disenchanted with academic philosophy because of its analytical bent and distance from the concerns of real life, Callahan found the ethical issues raised by the rapid medical advances of the 1960s—which included the birth control pill, heart transplants, and new capacities to keep very sick people alive—to be philosophical questions with immediate real-world relevance. In this memoir, Callahan describes his part in the founding of bioethics and traces his thinking on critical issues including embryonic stem cell research, market-driven health care, and medical rationing. He identifies the major challenges facing bioethics today and ruminates on its future. Callahan writes about founding the Hastings Center—the first bioethics research institution—with the author and psychiatrist Willard Gaylin in 1969, and recounts the challenges of running a think tank while keeping up a prolific flow of influential books and articles. Editor of the famous liberal Catholic magazine Commonweal in the 1960s, Callahan describes his now-secular approach to issues of illness and mortality. He questions the idea of endless medical “progress” and interventionist end-of-life care that seems to blur the boundary between living and dying. It is the role of bioethics, he argues, to be a loyal dissenter in the onward march of medical progress. The most important challenge for bioethics now is to help rethink the very goals of medicine.

This book looks at the current turmoil facing contemporary healthcare systems worldwide, which has resulted from relentless reorganization being imposed upon them, and argues for a return to a values-based approach to healthcare. Writing from the unique and fresh perspective of social anthropology, the author takes a highly logical approach to practice and emphasizes the importance of values such as compassion, solidarity and social justice. He stipulates that without being able to clearly identify the values and goals that unite its members, healthcare organizations are unlikely to be able to meet the demands of the constant and varied pressures they face, and explains how individuals at every level in healthcare can contribute to positive change within their organizations. This much-needed and highly accessible book will be essential reading for anyone interested in healthcare reform from clinicians and nurses, to managers and policy makers as well as the interested reader.

American healthcare is neither efficient nor available to all, and is also the most expensive in the world. This book argues that rationing of healthcare could work and proposes an approach to ration fairly, effectively and generously.

This book analyzes policy fights about what counts as good evidence of safety and effectiveness when it comes to new health care technologies in the United States and what political decisions mean for patients and doctors. Medical technologies often promise to extend and improve quality of life but come with many questions: Are they safe and effective? Are they worth the cost? When should they be allowed on the market, and when should Medicare, Medicaid, and private insurance companies be required to pay for drugs, devices, and diagnostic tests? Using case studies of disputes about the value of mammography screening; genetic testing for disease risk; brain imaging technologies to detect biomarkers associated with Alzheimer's disease; cell-based therapies; and new, expensive drugs, Maschke and Gusmano illustrate how scientific disagreements about what counts as good evidence of safety and effectiveness are often swept up in partisan fights over health care reform and battles among insurance and health care companies, physicians, and patient advocates. Debating Modern Medical Technologies: The Politics of Safety, Effectiveness, and Patient Access reveals stakeholders' differing values and interests regarding patient choice, physician autonomy, risk assessment, government intervention in medicine and technology assessment, and scientific innovation as a driver of national and global economies. It will help readers to understand the nature and complexity of past and current policy disagreements and their effects on patients.

This issues-based reference work (available in both print and electronic formats) shines a spotlight on health care policy and practice in the United States. Impassioned debates about the best solutions to health care in America have perennially erupted among politicians, scholars of public policy, medical professionals, and the general public. The fight over the Health Care Reform Act of 2010 brought to light a multitude of fears, challenges, obstacles, and passions that often had the effect of complicating rather than clarifying the debate. The discourse has never been more heated. The complex issues that animate the health care debate have forced the American public to grapple with the exigencies of the present system with regard to economic, fiscal, and monetary policy, especially as they relate to philosophical, often ideologically driven approaches to the problem. Americans have also had to examine their ideas about the relationship of the individual to and interaction with the state and the varied social and cultural beliefs about what an American solution to the problem of health care looks like. In light of the need to keep students, researchers, and other interested readers informed and up-to-date on the issues surrounding health care in the U.S., this volume uses introductory essays followed by point/counterpoint articles to explore prominent and perennially important debates, providing readers with views on multiple sides of this complex issue. Features & Benefits: The volume is divided into three sections, each with its own Section Editor: Quality of Care Debates (Dr. Jennie Kronenfeld), Economic & Fiscal Debates (Dr. Mark Zezza), and Political, Philosophical, & Legal Debates (Prof. Wendy Parmet). Sections open with a Preface by the Section Editor to introduce the broad theme at hand and provide historical underpinnings. Each Section holds 12 chapters addressing varied aspects of the broad theme of the section. Chapters open with an objective, lead-in piece (or "headnote") followed by a point article and a counterpoint article. All pieces (headnote, point article, counterpoint article) are signed. For each chapter, students are referred to further readings, data sources, and other resources as a jumping-off spot for further research and more in-depth exploration. Finally, the volume concludes with a comprehensive index, and the electronic version of the book includes search-and-browse features, as well as the ability to link to further readings cited within chapters should they be available to the library in electronic format.

How partisanship, polarization, and medical authority stand in the way of evidence-based medicine The U.S. medical system is touted as the most advanced in the world, yet many common treatments are not based on sound science. Unhealthy Politics sheds new light on why the government's response to this troubling situation has been so inadequate, and why efforts to improve the evidence base of U.S. medicine continue to cause so much political controversy. This critically important book paints a portrait of a medical industry with vast influence over which procedures and treatments get adopted, and a public burdened by the rising costs of health care yet fearful of going against "doctor's orders." Now with a new preface by the authors, Unhealthy Politics offers vital insights into the limits of science, expertise, and professionalism in American politics.