Enemies of patients /
Ruth Macklin.
New York : Oxford University Press, 1993.
viii, 250 p. ; 25 cm.
0195072006 (acid-free paper) :
More Details
New York : Oxford University Press, 1993.
0195072006 (acid-free paper) :
catalogue key
Includes bibliographical references and index.
A Look Inside
Full Text Reviews
Appeared in Publishers Weekly on 1993-03-15:
Clinton's health system reform team would do well to read this study by Macklin, professor of bioethics at New York City's Albert Einstein College of Medicine--for Macklin seeks to disentangle the increasingly complicated, even adversarial relations between the medical establishment and its patients. Her account is detailed and persuasive. Although doctors appear to focus on the medical interests of patients, the author explains, doctors are often accused of being their patients' ``enemies'' by patient advocate groups. Further, there are other culpable forces intruding on patients' well-being, such as insurance companies and hospital management. Macklin points out that the 1973 12-point Bill of Patient Rights and the 1991 Patient Self-Determination Act helped to establish patient participation in the decision-making process, as stipulated in patients' legally binding ``advance directives''--such as Living Wills and surrogate mothers. To forestall malpractice or negligence suits, hospitals have responded by hiring ``risk managers'' to monitor and to act as liaison agents between all parties, including families. Macklin's book could steer reformers in the right direction. (May)
Appeared in Choice on 1993-09:
Modern medical technology designed and utilized to save lives, laws and regulations instituted to protect patients, and concerns about the fear of medical liability and rising health care costs have yielded unanticipated consequences and difficult ethical dilemmas for health care professionals and patients alike. These and other forces get in the way of the patient-physician relationship, limiting the ability of the physician to act in the best interest of the patient, restricting the right of patients to exert self-determination, and creating an environment where physicians feel powerless. Macklin, a highly regarded medical ethicist, the author or editor of eight books and more than 100 published professional articles, describes the growing number of forces that are hostile to the patient, the physician, and their relationship. She discusses how health care professionals, lawyers, hospital administrators, government regulators, insurance companies, etc., often with the best of intentions but with narrowly focused objectives in a fragmented health delivery system, all undermine the quality of patient care. Macklin has organized this book into clearly presented case studies that serve as models for specific problem areas; each concludes with a readable ethical analysis. For anyone who is a potential patient. R. L. Jones; Pennsylvania State University, Hershey Medical Center
This item was reviewed in:
Kirkus Reviews, March 1993
Publishers Weekly, March 1993
Choice, September 1993
To find out how to look for other reviews, please see our guides to finding book reviews in the Sciences or Social Sciences and Humanities.
Table of Contents
Enemies and advocates of patients
Law as an advocate for patients: A case study of DNR
Bureaucrats at the bedside: Risk management
The fetal police: Enemies of pregnant women
Doctors vs. patients and patients vs. patients
Doctors who feel threatened by patients
Physicians as fiscal gatekeepers: Rationing at the bedside
Medical futility: The limits of patient autonomy?
Patient autonomy, physician assisted suicide, and euthenasia
Ethics committees as advocates for patients
Table of Contents provided by Publisher. All Rights Reserved.

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