False Hopes: Overcoming the Obstacles to a Sustainable, Affordable Medicine / Edition 1

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False Hopes confronts head-on the until-now unassailable orthodoxy of one of the most powerful institutions in America - the medical establishment. Doctors and nurses, hospital administrators and medical researchers, and pharmaceutical and medical technology companies are all united in a relentless pursuit of unlimited medical progress: nothing less ambitious than the conquest of all disease and the indefinite extension of lifespans. Daniel Callahan shows how this very quest for perfection, shared by the society as a whole, is at the core of today's health care crisis, not only in the United States, where the costs of care are still covered primarily by private insurers, but also in countries with government-funded universal health care. Callahan proposes a sustainable, steady-state medicine that bows to the biological limits of human nature and gives priority to meeting basic needs. It would have as its goals preventing and treating diseases that afflict the many rather than the few, improving the quality of life of the elderly and the chronically ill, and focusing our resources on primary care and public health measures.

"...traces the root of America's health care crisis, not to inefficient organization or waste, but to society's relentless quest for perfection...boldly proposes a sustainable approach."

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Editorial Reviews

Publishers Weekly - Publisher's Weekly
Callahan (What Kind of Life: The Limits of Medical Progress) here advocates a "sustainable, steady-state medicine" that stops consuming ever-more resources yet provides affordable health care "equitably accessible to all." High-tech medicine's pursuit of the eradication of all diseases and unlimited progress are no longer viable, he contends in his farsighted, visionary manifesto. Callahan examines the obstaclessocial, financial, politicalfacing his modest agenda for medicine, but he nevertheless feels it can be accomplished through a combination of improved public health programs, emphasis on greater personal responsibility to alleviate such conditions as obesity and heart disease and a drastic reallocation of resources away from acute care toward massive preventive and educational efforts. While much of his thoroughgoing analysis seems directed primarily to medical professionals and policymakers, his clearly written prescription will open a dialogue among health-care critics and reformers, establishment defenders, holistic healers and the public. (Apr.)
Library Journal
With millions of dollars going into continuous research, the medical establishment has vested interests in promoting the idea that all diseases can be overcome and unlimited progress is possible. Not so, Callahan declares. Instead, he argues for a "sustainable" healthcare policy to meet basic needs and contain costs. (LJ 4/1/98)
Callahan proposes a health care system to meet the most basic needs of Americans that focuses on preventing and treating diseases that afflict the many rather than the few, thus improving the quality of life for the elderly and chronically ill and concentrating resources on primary care and public health. He argues that US society must rethink its attitude toward death and sickness if the health care system is to be sustainable. The 1998 cloth edition was published by Simon and Schuster. Annotation c. Book News, Inc., Portland, OR (booknews.com)
Roy Porter
"False Hopes" offers a voice of sanity....Callahan's forte lies in soberly addressing how much health we can reasonably expect to buy. Here he squarely faces a fact of life pointed out years ago by the English politician Enoch Powell: "There is virtually no limit to the amount of health care an individual is capable of absorbing." -- Roy Porter, New York Times Book Review
Kirkus Reviews
Medical ethicist Callahan (The Troubled Dream of Life, 1993, etc.) proposes a new way of looking at the nature of medicine that sharply challenges traditional beliefs in progress and perfectibility. At the Hastings Center in 1992 the author initiated a four-year project, þThe Goals of Medicine: Setting New Priorities,þ in which research groups from 14 countries addressed questions about the future of medicine. This book is a parallel project. If Callahan had a bumper sticker, its message might well be "Enough Already," but slogans aren't his weapons of choice. His forte is critical analysis, which he applies rigorously to the values of modern medicine. In his view, faith in limitless progress and the drive to dominate nature (through expensive high-tech procedures and the attempt to conquer death), and expansion of its domain into social problems such as teenage pregnancy and drug abuse make modern medicine neither socially equitable nor economically sustainable. Callahan proceeds to define a sustainable and equitable medicine and its implications for health policy: The focus must shift from individual health improvement to population health improvement through þa comprehensive system of primary care medicineþ oriented to health promotion and disease prevention. Further, the drive toward total risk reduction and medical perfectionism must be curbed. And finally, efforts to overcome death must be replaced by the goal of improving the quality of life within a limited life cycle, i.e., the average life span now attained in developed countries. Not only must research rein in its goals and promises of ever-improving life, but patients must lower their demandsand expectations. In brief, sustainable and equitable medicine means decent care for all, not state-of-the-art care for the few. Callahan is a powerful presenter of ideas, anticipating challenges and providing persuasive arguments, and his controversial thoughts on the future of medicine are sure to stimulate discussion among health-care policymakers.
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Product Details

  • ISBN-13: 9780813526744
  • Publisher: Rutgers University Press
  • Publication date: 3/28/1999
  • Edition number: 1
  • Pages: 334
  • Product dimensions: 5.54 (w) x 8.50 (h) x 0.75 (d)

Table of Contents

Preface 13
1 Creating a Sustainable Medicine 25
2 Arguing with Success: Progress and the Medical Dream 46
3 Sustainable Technology: A Medical Oxymoron? 84
4 Two-faced Nature: Medical Friend or Medical Foe? 112
5 Self, Society, and Suffering 139
6 Public Health and Personal Responsibility 173
7 Can This Marriage Succeed? Medicine and the Market 208
8 Equity and a Steady-State Medicine 240
9 Sustainable Medicine, Sustainable Hope 275
Notes 291
Index 317
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