Most of us want and expect medicine's miracles to extend our lives. In today's aging society, however, the line between life-giving therapies and too much treatment is hard to see--it's being obscured by a perfect storm created by the pharmaceutical and biomedical industries, along with insurance companies. In Ordinary Medicine Sharon R. Kaufman investigates what drives that storm's "more is better" approach to medicine: a nearly invisible chain of social, economic, and bureaucratic forces that has made once-extraordinary treatments seem ordinary, necessary, and desirable. Since 2002 Kaufman has listened to hundreds of older patients, their physicians and family members express their hopes, fears, and reasoning as they faced the line between enough and too much intervention. Their stories anchor Ordinary Medicine. Today's medicine, Kaufman contends, shapes nearly every American's experience of growing older, and ultimately medicine is undermining its own ability to function as a social good. Kaufman's careful mapping of the sources of our health care dilemmas should make it far easier to rethink and renew medicine's goals.
Sharon R. Kaufman is Chair of the Department of Anthropology, History and Social Medicine at the University of California, San Francisco. She is the author of ...And a Time to Die: How American Hospitals Shape the End of Life.
Table of Contents
Acknowledgments ix Introduction. Diagnosing Twenty-First-Century Health Care 1 Part I: The Quandry and Unexamined Ordinariness of Twenty-First-Century Medicine 1. Ordinary Medicine in Our Aging Society: The Dilemma of Longevity 21 Part II. The Chain of Health Care Drivers 2. The Medical-Industrial Complex I: Evidence-Based Medicine, the Biomedical Economy, and the Ascendance of Clinical Trials 53 3. The Medical-Industrial Complex II: Access, Industry, and the Clincial Trials Phenomenon 79 4. "Reimbursement Is Critical for Everything": Medicare and the Ethics of Managing Life 99 Part III: Medicine's Changing Means and Ends 5. Standard and Necessary Treatments: The Changing Means and Ends of Technology 127 6. Family Matters: Kidneys and New Forms of Care 165 7. Influencing the Character of the Future: Prognosis, Risk, and Time Left 195 8. For Whose Benefit? Our Shared Quandary 217 Conclusion. Toward a New Social Contract? 238 Notes on the Research 249 Notes 255 Bibliography 285 Index 307
God's Hotel: A Doctor, a Hospital, and a Pilgrimage to the Heart of Medicine - Victoria Sweet
"Sharon R. Kaufman has made an important and disturbing discovery about the links between for-profit healthcare companies, so-called evidence-based medicine, doctors, and patients. Ordinary Medicine should be read, thought about, and acted upon by those who have the power to effect change."
Cutting for Stone - Abraham Verghese
"Ordinary Medicine is an exploration of how what is essentially experimental medicine can become 'standard care.' In this thoroughly researched book, many of our assumptions are shaken. The system that is extant would seem aligned to prevent us from accepting death as a natural life progression and offering in its place prolonged suffering. A truly engaging and provocative read."
How We Live - Victor R. Fuchs
"The recommendation by the AMA to Medicare to begin paying physicians for discussions with patients about end-of-life care makes this new book by Sharon Kaufman particularly timely. She explains why the present health care system is biased toward excess treatment at the end of life, and advocates a broad approach to health care reforms that goes beyond cost control to encompass social and ethical considerations."
Knocking on Heaven's Door: The Path to a Better Way of Death - Katy Butler
"I devoured Ordinary Medicine. It gave me courage. It helped me delineate, sometimes for the first time, the interlocking forces and practices that have helped create an epidemic of unnecessary suffering at the end of life. Breathtaking in its scope, rigor, and intellectual range, this book will help readers take back control of their lives and deaths from the forces that have created an 'ordinary' end-of-life medicine that is far from ordinary."
