Medicine S Dilemmas

Can the United States provide a health care program that offers a comprehensive package of the highest-quality health benefits to all Americans while containing health care costs? In this important book, Dr. William L. Kissick says that it cannot: no society in the world has sufficient resources to provide all the health services its population is capable of utilizing. Dr. Kissick was an active participant in the drafting of Medicare legislation in the 1960s and for the past twenty-five years has held joint positions in a medical school and a business school where he has specialized in health care management. Drawing on his long experience in the field, he discusses the dimensions of the current crisis, the financial and medical implications of alternative proposals--including the program put forth by the Clinton administration--and the requirements for long-term strategies. He argues that although there are no ideal solutions to health care reform, there are many significant programs at the regional, state, and local level that can serve as prototypes for the restructuring of the organization, financing, and delivery of health services. Dr. Kissick discusses some of these alternatives and suggests that after the federal government legislates a health care policy, it should be implemented through collaboration with state and local initiatives, for such programs have been built on an understanding of regional needs, expectations, and cultural diversity.

"[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.

An introduction to the new health care for profit. Legal differences between investor-owned and nonprofit health care institutions. Wall Street and the for-profit hospital management companies. When investor-owned corporations buy hospitals: some issues and concerns. Physician involvement in hospital decision making. Economic incentives and clinical decisions. Ethical dilemmas of for-profit enterprise in health care. Secondary income from recommended treatment: should fiduciary principles constrain physician behavior?

Now in its Fifth Edition, this respected reference helps readers tackle the common and often challenging ethical issues that affect patient care. The book begins with a concise discussion of clinical ethics that provides the background information essential to understanding key ethical issues. Readers then explore a wide range of real-world ethical dilemmas, each accompanied by expert guidance on salient issues and how to approach them. The book’s two-color design improves retention of material for visual learners. An accompanying website lets readers access the full text, along with features designed to reinforce understanding and test knowledge. New to the Fifth Edition: This edition includes new discussions of ethical issues as they relate to clinical practice guidelines and evidence-based medicine, electronic medical records, genetic testing, and opioid prescription. The book also includes an increased focus on ethical issues in ambulatory care. Readers will also find more detailed analysis of cases, more examples of ethical reasoning, more highlight pages relating clinical ethics to emergency medicine, oncology, palliative care, and family medicine. Also new are discussions of quality improvement and use of advance care planning rather than advance directives.

One of the eXCltmg challenges of medicine has been the reaching of decisions based on less than complete evidence. As undergraduates in teaching hospitals future physicians are taught to think in clear and absolute black and white terms. Diagnoses in teaching hospitals all are based on supportive positive findings of in vestigations. Treatment follows logically on precise diagnosis. When patients die the causes of death are confirmed at autopsy. How very different is real life in clinical practice, and particularly in family medicine. By the very nature of the common conditions that present diagnoses tend to be imprecise and based on clinical assessment and interpretation. Much of the management and treatment of patients is based on opinions of individual physicians based on their personal expenences. Because of the relative professional isolation offamily physicians within their own practices, not unexpectedly divergent views and opinions are formed. There is nothing wrong in such divergencies because there are no clear absolute black and white decisions. General family practice functions in grey areas of medicine where it is possible and quite correct to hold polarized distinct opinions. The essence of good care must be eternal flexibility and readiness to change long-held cherished opinions. To demonstrate that with many issues in family medicine it is possible to have more than one view I selected 10 clinical and II non -clinical topics and invited colleagues and fellow-practitioners to enter into a debate-in-print.

Publisher's Note: Products purchased from 3rd Party sellers are not guaranteed by the Publisher for quality, authenticity, or access to any online entitlements included with the product. What are the ethical issues raised by the increasing use of big data and artificial intelligence in health care? How should physicians respond when they have a conscientious objection to an intervention requested by a patient? How should health care organizations respond to physician requests? How can physicians best help patients make informed decisions about end-of-life and life-sustaining care? How should interns and residents respond to ethical dilemmas created by duty hours restrictions? Resolving Ethical Dilemmas: A Guide for Clinicians helps residents, students, and practitioners work through these and many more common and challenging ethical questions that affect patient care. The 6th Edition reflects important changes in medicine and healthcare policy and provides additional clarity to complex concepts. Offering practical, real-world advice, it helps you think through and resolve difficult cases, prompting thoughtful, well-reasoned answers to the question of “What do I do in this situation?”

The Best Pharmaceuticals for Children Act (BPCA) and the Pediatric Research Equity Act (PREA) were designed to encourage more pediatric studies of drugs used for children. The FDA asked the IOM to review aspects of pediatric studies and changes in product labeling that resulted from BPCA and PREA and their predecessor policies, as well as assess the incentives for pediatric studies of biologics and the extent to which biologics have been studied in children. The IOM committee concludes that these policies have helped provide clinicians who care for children with better information about the efficacy, safety, and appropriate prescribing of drugs. The IOM suggests that more can be done to increase knowledge about drugs used by children and thereby improve the clinical care, health, and well-being of the nation's children.