Ordinary Medicine: Extraordinary Treatments, Longer Lives and Where to Draw the Line
Book Review
Kaufman, S. R. (2015). Ordinary medicine: Extraordinary treatments, longer lives, and where to draw the line [Electronic].
Ili Yang
The University of British Columbia
11/12/2016
Written about the structure and culture of biomedical heath care and a society that is attempting to prolong aging, Medicare funding, funding and development of research, and today’s definition of standard care, Sharon Kaufman brings to light the many dilemmas posed to the American health care system. Her ethnographic story, Ordinary Medicine: Extraordinary Treatments, Longer Lives and Where to Draw the Line reveals the booming biomedical research and clinical trials industry, the power held by Medicare and private insurance, and a rapidly changing standard of care once a medical treatment is considered reimbursable. This leads to systematic changes in the standard of care result in a massive amount of pressure being placed upon doctors, patients and families to make an ethically and medically sound decision in refusing or accepting therapy. Kaufman exposes the driving forces behind the expansion of biomedicine, society’s response to the growing industry on a personal and bureaucratic level. Though it is common knowledge that pharmaceutical companies, insurance companies and biomedicine are all interconnected, Ordinary Medicine gives insight to the degree of power
Escape Fire: The Fight To Rescue American Healthcare by Matthew Heineman and Susan Froemke addressed many issues seen in the American Healthcare system that have gone uncorrected for years. The importance of primary care physicians was noted and this view continued to make more and more sense as the film went on. The lifestyle choices that Americans are and have been making do not promote wellness and actually make the jobs of primary care physicians much more difficult. Also discussed in the film, was the severe issue of the overuse of narcotics in the military. The thought that alternative therapies can actually make a significant difference in people’s lives is to most people something that sounds completely insane. But, these therapies have been working for those that need them most. What truly impacted me during the film was how interconnected all of our problems in the American healthcare system are. The fixes seem to be possible and not as difficult as some would have others believe. After seeing this film I feel that I have gained a new respect and understanding of the system that I will be a part of in the not too distant future.
"In the past two decades or so, health care has been commercialized as never before, and professionalism in medicine seems to be giving way to entrepreneurialism," commented Arnold S. Relman, professor of medicine and social medicine at Harvard Medical School (Wekesser 66). This statement may have a great deal of bearing on reality. The tangled knot of insurers, physicians, drug companies, and hospitals that we call our health system are not as unselfish and focused on the patients' needs as people would like to think. Pharmaceutical companies are particularly ruthless, many of them spending millions of dollars per year to convince doctors to prescribe their drugs and to convince consumers that their specific brand of drug is needed in
In the article, “Our Big Appetite for Healthcare” written by Daniel J. Stone was in the March 31 2013 issue for Los Angeles Times. Doctor Stone intended audience are the reader of the Los Angeles Time. Stone’s purpose in this article is to persuade his readers that he wants to change the healthcare culture from “more is better” to “do what is medically indicated to provide the best outcome”. Stone supports his argument with strategies and evidence.
Henderson, a well known transplant specialist. Dr. Henderson believes medicine in the United States has become a repetitive system of doctors who prescribe patients with similar symptoms generic prescriptions, whether it is surgery or just a medicine, instead of focusing on the individual patient’s needs. He believes the inflation of medical care costs are associated with doctors doing the same thing over and over again. I can personally relate to this because, in February of 2015, I was emitted into the hospital due to excruciating stomach pains. The doctors did not know what was wrong with me, but after I was in the emergency room for over 48 hours, they decided to take out my appendix. Before I went into the surgery, the surgeon reassured me and my parents by saying she has done this surgery hundreds of times, proving an appendectomy is a go-to surgery for stomach pain. The uncertainty of the success of the surgery resolving the problem worried me and my family. Luckily, the surgery did eliminate the preexisting pain. If it had not, however, my parents would have been out thousands of dollars that would go directly to the surgeon’s pockets. Socialized medicine would be able to resolve problems like this one by increasing the quality, safety, and outcomes of each procedure. Dr. Henderson uses the example of Scotland to explain how socialized medicine increased the quality, safety, and outcomes of each procedure. Compared to the United States, Scotland is a lot more advanced medically. The United States can get to Scotland’s level of healthcare by adopting a program of socialized medicine similar to
In the article “Doctors Should Stop Treatment That Is Futile,” Kevin T. Keith argues that doctors should stop giving useless treatments to patients that won’t get any better. His audience is the healthcare network and the families of patients and he uses a serious tone to get their attention. Kevins purpose is to persuade doctors into stopping ineffective treatments. He uses ethos, pathos, and logos so support his claim.
But instead, it seems that what they are doing is feeding on each other hope. For example, patients remain hopeful that doctors can cure their diseases and doctors are hopeful that technology can deliver these changes to their patients. However, by feeding on their unrealistic hope, physicians enter without knowing into this vicious cycle for pushing for harsher and unrealistic means or treatments that endanger in the process the patient’s sense of dignity. That said, Susan ‘s physicians and his son, at one point, were victims of this cycle because they allowed, instead of alleviate the pain in Susan’s
My biggest concern regarding the future of medicine lies in the unequal access to quality, affordable healthcare. Having worked at two facilities with largely under and/or uninsured patient populations, I have directly witnessed the consequences suffered by those lacking insurance secondary to high costs. Without adequate coverage, regular appointments are not scheduled, symptoms are not addressed, and previously treatable illnesses transform into illnesses that are much less manageable and potentially even life threatening. Although significant strides have been made via the Affordable Care Act to reduce the outstanding numbers of uninsured Americans, an estimated thirty million still remain subject to out of pocket expenses should they fall
The authors of this article are Harriet Hutson Gray and Susan Cartier Poland. Gray is a reference and digital service librarian at the Kennedy Institute of Ethics at Georgetown University, and Poland is a Research Associate for the National Reference Center for Bioethics at Georgetown University. The article is intended for the US government and the general public about the uneven balance in the health care sector, and the long-term impact on medical practices. The article describes the luxurious treatments in the US that many cannot afford, and the people who are going overseas to get the treatment. The authors address the challenges the middle-classes must bear. When patients return home, aftercare could become a big challenge, as there may
As many as 45,000 people die per year from preventative diseases as a result of not having health insurance and as many as 22% of people on Medicaid are underinsured and not able to take measures towards preventative care (Bor et. al). However, this could get worse as more diseases become preventative with new research efforts. In 2013, Google, the famous search engine company and the company behind one of the fastest internet browsers of today, decided to tackle death by a creating subsidiary under them by the name of Calico. Calico has ambitious efforts with their slogan being, “We 're tackling aging, one of life 's greatest mysteries.” They aim to tackle many diseases today that are incurable or that are side effects of aging such as Alzheimer’s or certain types of cancer. While this venture is great and progressive, what are the ethical implications of it? This research is expensive with the research center costing 1.5 billion on its own. What happens when they actually develop something viable and useful? Who will get the cure? How much will the pill to cure someone’s cancer be and will only the rich have access and will insurance companies even cover it? If someone cannot afford that pill that will save their lives, is it ethical to turn them away? Well, according to our standards set as a society, no, it is not ethical to turn someone away from
Healthcare has evolved over the last few centuries from a small community based healthcare system and economy to a multi-billion dollar industry that drives how Americans live their lives. Through healthcare, Americans are able to live now into their eighties and nineties. With medical advances, chronic conditions, such as congestive heart failure or chronic obstructive pulmonary disease, that at one time were debilitating and led to palliative care, are now conditions that can be managed with one to two medications. More importantly, with the knowledge America is now mindful of, these conditions can be prevented. Through decades and decades of medicine, America has become tremendously conscientious of health.
Medicalization is something that has become overly common all over the world. It seems as if almost everything, from aging to deviant behaviors, is medicalized. Human beings have a tendency to want things their way, so they strive to get what they desire. Little do people know “each instance of medicalization represents an advance in medicine’s control over the human body” (Ferrante Ch. 6). This may not seem like a serious problem, but as medicalization increases so does the chances of danger towards people’s lives.
The term ‘modern day medicine’ is aging just like our society. The term ‘aging’ is not a new concept. However, the word seems to make individuals, uncomfortable, no matter the gender. Just the sight of gray hair seems to send people into a ‘a mid-life crisis’. The obsession with aging is not isolated to just the U.S. People all across the world are traveling to get Botox injections, face lifts, and Brazilian buttocks lifts. To
Medicine altered (wo)man in many different ways and changed the views upon the clinical gaze. Foucault explained the word "gaze," in the book. He called it an "clinical gaze" at times, and an "observing gaze" at others. The people of modernity thought that with this powerful gaze the physician could penetrate illusion and see through the reality that the physician had the power to see the hidden truth. Once the doctors got the ability to look with a clinical gaze the doctors could not diagnose the problem the patient is having and possibly find a solution and being able to speak about all things wisely. There wasn’t any possible way the doctors can be second-guessed with is experience. The doctors now could only tell you what to do and only the truth. There is a big historical switched with could be identifies with this quote. Foucault said “Knowledge linked to power, not only assumes the authority of ‘the truth’ but has power to make itself true’”. The clinical gaze is discourse that separates the individual’s identity from the individual’s body. ‘What is the matter with you?’, with which the eighteenth-century dialogue between doctor and patient began (a dialogue possessing its own grammar and style), was replaced by that other question: ‘Where does it hurt?’, in which we recognize the operation of the clinic and the principle of its entire discourse. “ ( xviii preface ) further on in the book we see that the medical field start to change. Medical language gave this so
“To Live On”, a 2005 art installation composed of roses and infusion bags by Min Jeong Seo, elegantly captures the idea of medical advancement of a double edged sword. Seo’s art piece involves fifty long stemmed roses, eerily suspended with the blooms perfectly preserved in infusion bags, while the stems hang freely, drying and decaying at their own pace. It’s an apt visual metaphor that showcases the good and bad consequences of constant medical research and development, one that addresses the concepts of “playing God” and where quality of life gives way to mere extension of it. While scientific progress has given society increasingly effective therapies and has allowed us to extend our collective life span, it has also led us into increasingly woolly territory where we must consider if genetically typing fetuses, blanket prescription writing or a systematic emphasis on tertiary care is compatible with a higher quality of life than if our bodies were left to their own devices. Unpacking these issues requires a degree of separation away from the medical field and the patients, practitioners and occasional overcommitment to scientific dogma that introduces biases and cloudy judgement into the question of how society should use its technology. This core tension has always fascinated me and has inspired me to constantly ask if the newest discovery is actually the best, or if a simpler, more effective solution already exists and someone just hasn’t figured out how to apply it.
The treatment of physical and mental problems has undergone a rapid change in the past few decades. An increasing number of bodily and behavioural symptoms now have a recognised medical diagnosis and corresponding treatment. Sociologists have attributed these changes to the process of medicalization, wherein “non-medical problems come to be defined and treated as if they were medical issues” (McLennan, McManus & Spoonley 2009: 271). Medicalization is an ongoing, gradual process which occurs through the social construction of new diseases by groups such as health professionals (Conrad 2007: 4). It can be argued that medicalization is an active and passive process by which diseases are constructed in an attempt to find treatments for patients; and that diseases can be ‘socially’ constructed as well as ‘corporately’ constructed by companies to create a profitable market of consumers. At the micro level of society, medicalization in the Western world has been influenced by liberal notions of individualization which has extended to some parts of the health sector. At the macro level, medicalization has been buoyed by the process of the professionalization, expansion of state monopoly over the health profession and religious and political social movements. Although some academics argue that the medicalization of society is less significant than the process of “de-medicalization”, there is clear evidence that the process of medicalization is intensifying and outstripping the rate