The Ethos of Medicine in Postmodern America: Philosophical, Cultural, and Social Considerations

by Arnold R. Eiser

Overview

Has postmodern American culture so altered the terrain of medical care that moral confusion and deflated morale multiply faster than both technological advancements and ethical resolutions? The Ethos of Medicine in Postmodern America is an attempt to examine this question with reference to the cultural touchstones of our postmodern era: consumerism, computerization, corporatization, and destruction of meta-narratives. The cultural insights of postmodern thinkers—such as such as Foucault, Deleuze and Guattari, Lyotard, Baudrillard, Bauman, and Levinas—help elucidate the changes in healthcare delivery that are occurring early in the twenty-first century. Although only Foucault among this group actually focused his critique on medical care itself, their combined analysis provides a valuable perspective for gaining understanding of contemporary changes in healthcare delivery. It is often difficult to envision what is happening in the psychosocial, cultural dynamic of an epoch as you experience it. Therefore it is useful to have a technique for refracting those observations through the lens of another system of thought. The prism of postmodern thought offers such a device with which to “view the eclipse” of changing medical practice. Any professional practice is always thoroughly embedded in the social and cultural matrix of its society, and the medical profession in America is no exception. In drawing upon of the insights of key Continental thinkers such and American scholars, this book does not necessarily endorse the views of postmodernism but trusts that much can be learned from their insight. Furthermore, its analysis is informed by empirical information from health services research and the sociology of medicine. Arnold R. Eiser develops a new understanding of healthcare delivery in the twenty-first century and suggests positive developments that might be nurtured to avoid the barren “Silicon Cage” of corporate, bureaucratized medical practice. Central to this analysis are current healthcare issues such as the patient-centered medical home, clinical practice guidelines, and electronic health records. This interdisciplinary examination reveals insights valuable to anyone working in postmodern thought, medical sociology, bioethics, or health services research.

Product Details

ISBN-13:	9780739181805
Publisher:	Lexington Books
Publication date:	12/24/2013
Pages:	218
Product dimensions:	6.00(w) x 9.10(h) x 0.80(d)

About the Author

Arnold R. Eiser is associate dean for Mercy Programs and professor of medicine at Drexel University College of Medicine. He also serves the Pennsylvania chapter of the American College of Physicians as the chair of its Health and Public Policy Committee.

Table of Contents

Introduction: The Ethos of Medicine in Postmodern America Chapter 1: The Ethos of Medical Practice in this Postmodern Age of Computerized Consumerism Chapter 2: The Social Construction of Medical Knowledge Chapter 3: The Culture of Medical Practice: Corporate Computerization versus the Face of the Other Chapter 4: Practical and Ethical Concerns Regarding Aspects of Quality Improvement Processes Chapter 5: The Uneven Encounter Between Postmodern Expectations and Corporate Control of Medical Practice Chapter 6: Power and Trust in the Patient-Physician Relationship: Postmodern Values and the Patient Centered Medical Home Chapter 7: Medical Education in Postmodern Society Chapter 8: Medical Professionalism: What Does Altruism Have to Do with It? Chapter 9: Postmodern Physician Ethos and Morale Chapter 10: Bioethics in Postmodern America Chapter 11: The. Ethos of Medicine, Peformativity, and the Silicon Cage Chapter 12: Medical Care is Embedded in American Culture: Repositioning the Medical Ethos for the 21st Century Epilogue Bibliography

Editorial Reviews

Since. .. 1977, numerous physicians, ethicists, economists, and sociologists have offered diagnoses and therapies for the health care industry’s ever growing dysfunction [in essays and books]. However, Arnold Eiser’s new book, The Ethos of Medicine in Postmodern America, is easily among the most comprehensive and well-documented of these analyses.. . .While other observers have described features of today’s medical ethos, e.g., consumerism, impersonality, self-interest, corporatization, and alienation, Eiser, quite rightly, locates all these features as aspects of the larger postmodern world view.. . .Dr. Eiser’s application of Levinas’ sensibility to medical practice is exciting because it relates the notion of professional obligation to empathy, emotional intelligence, and reflective practice, topics currently under active investigation.. . .The Ethos of Medicine in Postmodern America is a sobering book to read. It confirms and documents the widespread dysfunction in medicine. However, it also provides us with tools for understanding the problem and concrete suggestions for reviving ethics of respect and responsibility in the clinical encounter.

The Pharos

'Consumerism, computerization, and corporatization' dominate health care in the 21st century, for both practitioners and patients. These trends have changed the landscape of medicine, increased the speed at which new technology is incorporated into standard practice, and transformed the ethos of medicine today. Eiser examines these changes using observations from philosophers such as Lyotard, Bauman, Foucault, and others, with Foucault being the only one to examine medical care directly and doing so from a historical perspective. Eiser applies the work of philosophers, for example Lyotard's 'loss of grand narratives,' to medicine in the contemporary US. The book's 12 chapters address topics such as electronic medical records, evidence-based medicine, doctor-patient relationships, bioethics, and medical education. Though the title suggests a discussion of the current health care system in the US, Eiser also presents studies and references from abroad in a comparative context. Each chapter has extensive endnotes; a six-page bibliography at the end is organized by topic. Summing Up: Recommended. Upper-division undergraduates and above.

Choice

My bookshelves sag with books that decry the losses of modern medicine, while a distressingly small number contain practical solutions. Eiser challenges us to think about how consumerism, the pursuit of profit, computerized protocols, Internet doctor ratings, blogs, and multiple stakeholders affect the patient-physician relationship.. . .The Ethos of Medicine in Postmodern America is a thoughtful, informative book by an experienced clinician, educator, and ethicist. It introduces a broad view of a complex system about which we may have had simplistic opinions. This is primarily an American story, but similar changes are afoot in Canada and elsewhere.

Canadian Journal of General Internal Medicine

The Ethos of Medicine in Postmodern America is not solely about medicine but reaches much deeper into the multiplying fissures in the tissue of human togetherness in a society in which the public sphere is subsumed by advertising, marketing, entertainment, computerization, electronic gossip, and other interests devoid of ethical orientation, and in the result "morality is strictly privatized, individualized, compartmentalized in personalized space." It is a case study in a much wider phenomenon of moral insensitivity gnawing into the very foundation of social life in our society of consumers first, citizens distant second and fellow humans recast as competitors and rivals. This book is a warning that needs to be paid close attention by all of us worried about our societal future.

Zygmunt Bauman

The Ethos of Medicine in Postmodern America: Philosophical, Cultural, and Social Considerations could hardly have arrived at a more propitious time. As medicine becomes less a profession and more a business in the United States and elsewhere, there is a huge need to revisit the ethic of the doctor-patient relationship. While talk of individualized and personalized medicine is the rhetoric being marketed about that relationship within the new emerging business model, it is not at all clear how these concepts will be implemented in a manner that respects physician expertise, judgment, and advocacy as well as patient autonomy, need, and best interest. Dr. Arnold R. Eiser’s book takes a long, informed, serious, and useful look at this pressing ethical question.

Arthur L. Caplan

The practice of medicine has changed radically through the past half-century. Electronic health records, moves of physicians’ practices into corporate structures, for-profit hospital systems, and other changes, all influence the patient-physician relationship and standards in the conduct of medical care. Dr. Eiser’s survey of today’s American medicine makes clear why potential patients, current patients, and physicians should be aware of possible results of such influences. Can trust in physicians’ professional standards and the central importance of the physician-patient relationship be maintained? The Ethos of Medicine is a book you should read if you care about the future of medical care in the United States.

Edward J. Huth

'Consumerism, computerization, and corporatization' dominate health care in the 21st century, for both practitioners and patients. These trends have changed the landscape of medicine, increased the speed at which new technology is incorporated into standard practice, and transformed the ethos of medicine today. Eiser examines these changes using observations from philosophers such as Lyotard, Bauman, Foucault, and others, with Foucault being the only one to examine medical care directly and doing so from a historical perspective. Eiser applies the work of philosophers, for example Lyotard's 'loss of grand narratives,' to medicine in the contemporary US. The book's 12 chapters address topics such as electronic medical records, evidence-based medicine, doctor-patient relationships, bioethics, and medical education. Though the title suggests a discussion of the current health care system in the US, Eiser also presents studies and references from abroad in a comparative context. Each chapter has extensive endnotes; a six-page bibliography at the end is organized by topic. Summing Up: Recommended. Upper-division undergraduates and above.

CHOICE