The Goals of Medicine: The Forgotten Issues in Health Care Reform

Georgetown University Press
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Debates over health care have focused for so long on economics that the proper goals for medicine seem to be taken for granted; yet problems in health care stem as much from a lack of agreement about the goals and priorities of medicine as from the way systems function. This book asks basic questions about the purposes and ends of medicine and shows that the answers have practical implications for future health care delivery, medical research, and the education of medical students.

The Hastings Center coordinated teams of physicians, nurses, public health experts, philosophers, theologians, politicians, health care administrators, social workers, and lawyers in fourteen countries to explore these issues. In this volume, they articulate four basic goals of medicine — prevention of disease, relief of suffering, care of the ill, and avoidance of premature death — and examine them in light of the cultural, political, and economic pressures under which medicine functions. In reporting these findings, the contributors touch on a wide range of diverse issues such as genetic technology, Chinese medicine, care of the elderly, and prevention and public health.

The Goals of Medicine clearly demonstrates the importance of clarifying the purposes of medicine before attempting to change the economic and organizational systems. It warns that without such examination, any reform efforts may be fruitless.

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About the author

Mark J. Hanson is the associate for ethics and society at the Hastings Center.

The co-founder and former president of the Hastings Center, Daniel Callahan is currently the director of international programs for the Hastings Center and author of The Troubled Dream of Life, Setting Limits: Medical Goals in an Aging Society and What Kind of Life?: The Limits of Medical Progress (Georgetown University Press).

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Additional Information

Publisher
Georgetown University Press
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Published on
Oct 27, 2000
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Pages
256
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ISBN
9781589014442
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Language
English
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Genres
Medical / Ethics
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Content Protection
This content is DRM protected.
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Available on Android devices
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Eligible for Family Library

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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.

From the era of slavery to the present day, the first full history of black America’s shocking mistreatment as unwilling and unwitting experimental subjects at the hands of the medical establishment.

Medical Apartheid is the first and only comprehensive history of medical experimentation on African Americans. Starting with the earliest encounters between black Americans and Western medical researchers and the racist pseudoscience that resulted, it details the ways both slaves and freedmen were used in hospitals for experiments conducted without their knowledge—a tradition that continues today within some black populations. It reveals how blacks have historically been prey to grave-robbing as well as unauthorized autopsies and dissections. Moving into the twentieth century, it shows how the pseudoscience of eugenics and social Darwinism was used to justify experimental exploitation and shoddy medical treatment of blacks, and the view that they were biologically inferior, oversexed, and unfit for adult responsibilities. Shocking new details about the government’s notorious Tuskegee experiment are revealed, as are similar, less-well-known medical atrocities conducted by the government, the armed forces, prisons, and private institutions.

The product of years of prodigious research into medical journals and experimental reports long undisturbed, Medical Apartheid reveals the hidden underbelly of scientific research and makes possible, for the first time, an understanding of the roots of the African American health deficit. At last, it provides the fullest possible context for comprehending the behavioral fallout that has caused black Americans to view researchers—and indeed the whole medical establishment—with such deep distrust. No one concerned with issues of public health and racial justice can afford not to read Medical Apartheid, a masterful book that will stir up both controversy and long-needed debate.
In this heartfelt memoir from one of the youngest recipients of the transorbital lobotamy, Howard Dully shares the story of a painfully dysfunctional childhood, a misspent youth, his struggle to claim the life that was taken from him, and his redemption.

At twelve, Howard Dully was guilty of the same crimes as other boys his age: he was moody and messy, rambunctious with his brothers, contrary just to prove a point, and perpetually at odds with his parents. Yet somehow, this normal boy became one of the youngest people on whom Dr. Walter Freeman performed his barbaric transorbital—or ice pick—lobotomy.

Abandoned by his family within a year of the surgery, Howard spent his teen years in mental institutions, his twenties in jail, and his thirties in a bottle. It wasn’t until he was in his forties that Howard began to pull his life together. But even as he began to live the “normal” life he had been denied, Howard struggled with one question: Why?

There were only three people who would know the truth: Freeman, the man who performed the procedure; Lou, his cold and demanding stepmother who brought Howard to the doctor’s attention; and his father, Rodney. Of the three, only Rodney, the man who hadn’t intervened on his son’s behalf, was still living. Time was running out. Stable and happy for the first time in decades, Howard began to search for answers.

Through his research, Howard met other lobotomy patients and their families, talked with one of Freeman’s sons about his father’s controversial life’s work, and confronted Rodney about his complicity. And, in the archive where the doctor’s files are stored, he finally came face to face with the truth.

Revealing what happened to a child no one—not his father, not the medical community, not the state—was willing to protect, My Lobotomy exposes a shameful chapter in the history of the treatment of mental illness. Yet, ultimately, this is a powerful and moving chronicle of the life of one man.

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