Strangers at the Bedside: A History of How Law and Bioethics Transformed Medical Decision Making

By David J. Rothman | Go to book overview

CHAPTER 7
The Doctor as Stranger

PRACTICALLY every development in medicine in the post—World War II period distanced the physician and the hospital from the patient and the community, disrupting personal connections and severing bonds of trust. Whatever the index—whether ties of friendship, religion, ethnicity, or intellectual activity—the results highlight a sharp division between the lay world and the medical world. By the 1960s the two had moved so far apart that one could have asked a lay audience about the last time they spoke to a physician and had their clothes on, and they would have been unable to remember an occasion. By the same token, if one had asked physicians about their social contacts outside the profession, they would have been hard pressed to come up with examples. The separation from the hospital has become so extreme that columnist Meg Greenfield, in a 1986 commentary entitled "The Land of the Hospital," announced that she had "just come back from a foreign place worth reporting on ... a universe, really of its own," where she felt like "a tourist in an unfathomable, dangerous land." 1 In a spate of recent medical self-help books writers have advised patients to prepare to enter a hospital as though they were going on a trek in Nepal—take food and organize family and friends to provide necessary help. It has even been suggested that patients hang up school diplomas and pictures of their children to make certain that the chieftains of this exotic place know that they are valued persons in the outside world.

-127-

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Strangers at the Bedside: A History of How Law and Bioethics Transformed Medical Decision Making
Table of contents

Table of contents

  • Title Page *
  • Contents vii
  • Acknowledgments ix
  • Introduction - Making the Invisible Visible 1
  • Chapter 1 - The Nobility of the Material 15
  • Chapter 2 - Research at War 30
  • Chapter 3 - The Gilded Age of Research 51
  • Chapter 4 - The Doctor as Whistle-Blower 70
  • Chapter 5 - New Rules for the Laboratory 85
  • Chapter 6 - Bedside Ethics 101
  • Chapter 7 - The Doctor as Stranger 127
  • Chapter 8 - Life through Death 148
  • Chapter 9 - Commissioning Ethics 168
  • Chapter 10 - No One to Trust 190
  • Chapter 11 - New Rules for the Bedside 222
  • Epilogue 247
  • Appendix A - Citations to Henry Beecher's 1966 Article 263
  • Notes 266
  • Index 293
  • About the Author *
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