13 of 16 people found the following review helpful
Culture of Death,
This review is from: Culture of Death: The Assault on Medical Ethics in America (Hardcover)
This is a well written exposition of frightening changes in the values and practices of the medical profession. I found myself reading only a little at a time simply because the subject is painful to think about. It describes the development of a "culture," that is a school of thought and practice, that places little or no value on human life as such.
Its major strength is in the lucid discussion of intellectual developments and their effects in practice. It also relates many concrete cases and shows their inter-relationship with ideas and their acceptance.
The main weakness I see is that there is little consideration of the economics involved except for accasional references to managed care versus fee for service insurance. There is no discussion of the fact that traditional medical ethics, including the Hippocratic oath, arose in a world of private patients. When people chose (and paid) the physicians that treated them, the medical profession could hardly exist without patients' confidence that their interests would be paramount to those they gave such power over their lives. The treatment of those who couldn't pay helped assure those who could. The advent of insurance provided by third parties, employers or governments, was bound to change things. Few people can choose a job based on whether the insurance provided will pay the doctor of their choice. With payments coming from an insurer not selected by their patients, medical practitioners' loyalties had to be divided. We could expect thinkers to rationalize the division.