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Doody's Review ServiceReviewer: David M. Wallace, MD (Monmouth Medical Center)
Description: This comprehensive anthology, both modern and ancient, integrates diverse opinions about our concepts of health and disease. In effect, it brings together the philospophy of medicine and bioethics, and describes the ever- changing interrelationships and dependencies between the two fields.
Purpose: The book's purpose is eloquently expressed by Dr. Edmund Pelligrino in the foreword of the book. He states that philosophical discourse on concepts of disease and health are necessary to justify our moral choices. When concepts are seriously challenged, we are threatened with intellectual and moral disorientation. Medicine today is showing signs of this disorientation as there is no longer unanimity about its goals, meanings, or moral compass points. In addition, we are now uncertain about what constitutes normalcy, and about the boundaries where health ends and disease begins. Through this anthology, the merging of philosophy and medicine are deemed essential to the understanding of the complexities of modern day medicine. These are worthy objectives that I believe the contributors and editors have duly met.
Audience: This book is written for anyone interested in the study of the philosophy of medicine. It well may be that it becomes a preferred reference for medical students and residents in training. Perhaps its greatest worth could be for those practitioners who feel they need to rediscover their way in the complex world of medical practice. Under Dr. Caplan's expertise, this treatise is unrivaled it its authoritative direction.
Features: The book is divided into four parts with each containing six to eight selections written by the contributors. The 1st part deals with historical discussions. The report by Samuel Cartwright, MD on the "Diseases and Peculiarities of the Negro Race" is especially compelling as it relates to the prejudices that existed among physicians of the South in the midst of the Civil War. One can only wonder how these medical opinions persist today with relationship to health care disparities among minorities. The 2nd part discusses the characterizations of health and illness from "On the Distinction Between Disease and Illness" to "Diagnosing and Defining Disease." In part 3, the selection on "The Politics of Menopause" will raise eyebrows as the disease was defined and characterized by the male dominated profession of medicine in the 1960s. Part 4 deals with genetic disease and enhancement therapies and the future we may have at our disposal as it relates to positive and negative eugenics. Although not a shortcoming, the editors could have chosen other topics or the topics presented could have been flavored with a different point of view.
Assessment: This book is an excellent compilation of the concepts of health and disease by experts in the field of philosophy and bioethics. It should prompt and reinvigorate more scholars to study and publish on the interrelationship between the philosophy of medicine and bioethics.