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Enemies of Patients
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Enemies of Patients Hardcover - 1993

by Ruth Macklin


From the publisher

A young man, terminally ill and in extreme suffering, asks to be removed from life support, requesting morphine first so he'll be asleep when the machine stops. His physician agrees, but the hospital's chief administrator intervenes, arguing that the morphine might itself cause death, leaving
the physician open to criminal indictment for murder. To placate the administrator, the doctor and patient reach a grim compromise: life support will be disconnected first, and only after manifest signs of suffering appear will the physician administer the morphine, to alleviate pain. The patient's
request is ultimately respected, but many staff members feel he has been made to suffer needlessly.
This is just one of many cases Ruth Macklin discusses in Enemies of Patients, an eye-opening look at the growing number of forces that are hostile to the interests of patients, including hospital administrators, lawyers who represent hospitals, insurance companies, government regulations, and even
some well intentioned physicians. Macklin, a highly regarded medical ethicist, the author of Mortal Choices and the subject of a New York Times Magazine cover story, provides a behind-the-scenes look at how the patient's ethical rights are often violated. She describes, for instance, how a new breed
of hospital administrator, the risk manager, acts consistently as an enemy of the patient, often urging physicians to continue aggressive, expensive treatments for critically ill patients--even when the patient and doctor agree the treatment should cease--for fear of lawsuits, bad publicity, or
criminal indictment. (Macklin points out, for instance, that even though no physician has ever been convicted of a crime for withdrawing treatment from a patient in a permanent vegetative state, hospital lawyers and risk managers regularly assert that there is a danger of criminal liability in such
cases.) The government also can become an enemy of patients. The most egregious case, according to Macklin, is the Federal government's "gag rule" which has prohibited health care facilities that receive Title X funds from discussing abortion with pregnant women, violating the patient's right to
full information. And physicians themselves can become enemies of patients. Some, seeing themselves as fiscal gatekeepers, ration expensive health care procedures on financial rather than medical grounds. Some physicians refuse to treat patients who don't follow their advice (a cardiologist, for
instance, who will not take care of patients who smoke) and others won't treat patients who pose a threat of lawsuit (such as a California woman in need of life-sustaining dialysis, who had previously sued another physician).
Packed with numerous case histories drawn from the author's experience in a major urban medical center, Enemies of Patients will give readers a better understanding of their rights as patients and show them how to forge an alliance with their doctors against common enemies.

Details

  • Title Enemies of Patients
  • Author Ruth Macklin
  • Binding Hardcover
  • Edition First Edition
  • Pages 272
  • Volumes 1
  • Language ENG
  • Publisher Oxford University Press, USA, New York
  • Date 1993-03
  • ISBN 9780195072006 / 0195072006
  • Weight 1.18 lbs (0.54 kg)
  • Dimensions 9.5 x 6.38 x 0.97 in (24.13 x 16.21 x 2.46 cm)
  • Library of Congress subjects Physician and patient, Medical ethics
  • Library of Congress Catalog Number 92016894
  • Dewey Decimal Code 174.2

About the author


About the Author:
Ruth Macklin is Professor of Bioethics at Albert Einstein College of Medicine. She is the author or editor of eight books, including Mortal Choices, and has published over one hundred articles in professional journals.
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Enemies of Patients: How doctors are losing their power & patients are losing their rights
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Enemies of Patients: How doctors are losing their power & patients are losing their rights

by Macklin, Ruth

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Enemies of Patients
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Enemies of Patients

by Macklin, Ruth

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New York: New York: Oxford Univ Pr, 1993. clean tight and unmarked in unclipped dj with edge bumps and slight soiling.... From Publishers Weekly. health system reform team would do well to read this study by Macklin, professor of bioethics at New York City's Albert Einstein College of Medicine--for Macklin seeks to disentangle the increasingly complicated, even adversarial relations between the medical establishment and its patients. Her account is detailed and persuasive. Although doctors appear to focus on the medical interests of patients, the author explains, doctors are often accused of being their patients' "enemies" by patient advocate groups. Further, there are other culpable forces intruding on patients' well-being, such as insurance companies and hospital management. Macklin points out that the 1973 12-point Bill of Patient Rights and the 1991 Patient Self-Determination Act helped to establish patient participation in the decision-making process, as stipulated in… Read More
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Enemies of Patients
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Enemies of Patients

by Ruth Macklin

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ISBN 13
9780195072006
ISBN 10
0195072006
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