Nursing and technology have been inexorably linked since the beginnings of trained nursing in the United States in the late nineteenth century. Whether or not they thought of the devices they used as technology, nurses have necessarily used a variety of tools, instruments, and machines—from thermometers to cardiac monitors—to appraise, treat, and comfort patients. Tracing the relationship between nursing and technology from the 1870s to the present, Margarete Sandelowski argues that technology has helped shape and intensify persistent dilemmas in nursing and that it has both advanced and impeded the development of the profession. Sandelowski examines key moments in the history of nursing that dramatize the ironies of the nursing-technology relationship. She demonstrates that nurses both embraced and rejected technology in their pursuit of cultural visibility and professional autonomy—with varying amounts of success. As one of the domains of female work historically most subject to sex segregation, Sandelowski notes, nursing provides an ideal site in which to examine the interplay of technology and gender.

The Clinton administration's failed health care reform was not the first attempt to establish government-sponsored medical coverage in the United States. From 1915 to 1920, Progressive reformers led a spirited but ultimately unsuccessful crusade for compulsory health insurance in New York State. Beatrix Hoffman argues that this first health insurance campaign was a crucial moment in the creation of the American welfare state and health care system. Its defeat, she says, gave rise to an uneven and inegalitarian system of medical coverage and helped shape the limits of American social policy for the rest of the century. Hoffman examines each of the major combatants in the battle over compulsory health insurance. While physicians, employers, the insurance industry, and conservative politicians forged a uniquely powerful coalition in opposition to health insurance proposals, she shows, reformers' potential allies within women's organizations and the labor movement were bitterly divided. Against the backdrop of World War I and the Red Scare, opponents of reform denounced government-sponsored health insurance as "un-American" and, in the process, helped fashion a political culture that resists proposals for universal health care and a comprehensive welfare state even today.

In this multidisciplinary study, Ann Folwell Stanford reads literature written by U.S. women of color to propose a rethinking of modern medical practice, arguing that personal health and social justice are inextricably linked. Drawing on feminist ethics to explore the work of eleven novelists, Stanford challenges medicine to position itself more deeply within the communities it serves, especially the poor and marginalized. However, she also argues that medicine must recognize its limits and join forces with the nonmedical community in the struggle for social justice. In literary representations of physical and emotional states of illness and health, Stanford identifies issues related to public health, medical ethics, institutionalized racism, women's health, domestic abuse, and social justice that are important to discussions about how to improve health and health care. She argues that in either direct or indirect ways, the eleven novelists considered here push us to see health not only as an individual condition but also as a complex network of individual, institutional, and social changes in which wellness can be a possibility for the majority rather than a privileged few. The novelists whose works are discussed are Toni Cade Bambara, Paule Marshall, Gloria Naylor, Leslie Marmon Silko, Toni Morrison, Louise Erdrich, Sandra Cisneros, Bebe Moore Campbell, Sapphire, Ana Castillo, and Octavia Butler.

Those who work in bioethics and the medical humanities come from many different backgrounds, such as health care, philosophy, law, the social sciences, and religious studies. The work they do also varies consulting on ethical issues in patient care, working with legislatures, dealing with the media, teaching, speaking, writing and more. Writing as a participant in this developing field, Judith Andre offers a model to unify its diversity. Using the term "bioethics" broadly, to include all the medical humanities, she articulates ideals for the field, identifies its temptations and moral pitfalls, and argues for the central importance of certain virtues. Perhaps the most original of these is the virtue of choosing projects well, which demands not only broadening the field's focus but also understanding the forces that have kept it too narrow. Andre offers an imaginative analysis of the special problems presented by interdisciplinary work and discusses the intellectual virtues necessary for its success. She calls attention to the kinds of professional communities that are necessary to support good work. The book draws from interviews with many people in the field and from the findings of social scientists. It includes the author's personal reflections, several extended allegories, and philosophical analysis. <!—copy for pb Those who work in bioethics and the medical humanities come from many different health care, philosophy, law, social sciences, religious studies, and more. The work they do also varies widely. Writing as a participant in this developing field, Judith Andre offers a model to unify its diversity. Using the term "bioethics" broadly, to include all the medical humanities, she articulates ideals for the field, identifies its temptations and moral pitfalls, and argues for the central importance of certain virtues. \—>

Prozac and its chemical cousins, Paxil, Celexa, and Zoloft, are some of the most profitable and most widely used drugs in America. Their use in the treatment of a multitude of disorders—from generalized anxiety disorder and premenstrual syndrome to eating disorders and sexual compulsions—has provoked a whirlwind of public debate. Talk shows ask, Why is Prozac so popular? What, exactly, do these drugs treat? But sustained critical discussion among bioethicists and medical humanists has been surprisingly absent. The eleven essays in Prozac as a Way of Life provide the groundwork for a much-needed philosophical discussion of the ethical and cultural dimensions of the popularity of SSRI antidepressants. Focusing on the increasing use of medication as a means of self-enhancement, contributors from the fields of psychiatry, psychology, bioethics, and the medical humanities address issues of identity enhancement, the elasticity of psychiatric diagnosis, and the aggressive marketing campaigns of pharmaceutical companies. They do not question the fact that these antidepressants can, in some cases, provide great benefit to alleviate real suffering. What they do question is the abundant popularity of these drugs and that popularity's relationship to American culture and ideas of selfhood. Tod Chambers, Northwestern University Feinberg School of Medicine, Chicago David DeGrazia, George Washington University James C. Edwards, Furman University Carl Elliott, University of Minnesota Center for Bioethics David Healy, University of Wales College of Medicine Laurence J. Kirmayer, McGill University Peter D. Kramer, Brown University Erik Parens, The Hastings Center Lauren Slater, AfterCare Services, Boston Susan Squier, Pennsylvania State University Laurie Zoloth, Northwestern University Center for Genetic Medicine, Chicago

In February 2003, an undocumented immigrant teen from Mexico lay dying in a prominent American hospital due to a stunning medical oversight—she had received a heart-lung transplantation of the wrong blood type. In the following weeks, Jesica Santillan's tragedy became a portal into the complexities of American medicine, prompting contentious debate about new patterns and old problems in immigration, the hidden epidemic of medical error, the lines separating transplant "haves" from "have-nots," the right to sue, and the challenges posed by "foreigners" crossing borders for medical care. This volume draws together experts in history, sociology, medical ethics, communication and immigration studies, transplant surgery, anthropology, and health law to understand the dramatic events, the major players, and the core issues at stake. Contributors view the Santillan story as a morality about the conflicting values underpinning American health care; about the politics of transplant medicine; about how a nation debates deservedness, justice, and second chances; and about the global dilemmas of medical tourism and citizenship. Charles Bosk, University of Pennsylvania Leo R. Chavez, University of California, Irvine Richard Cook, University of Chicago Thomas Diflo, New York University Medical Center Jason Eberl, Indiana University-Purdue University Indianapolis Jed Adam Gross, Yale University Jacklyn Habib, American Association of Retired Persons Tyler R. Harrison, Purdue University Beatrix Hoffman, Northern Illinois University Nancy M. P. King, University of North Carolina at Chapel Hill Barron Lerner, Columbia University Mailman School of Public Health Susan E. Lederer, Yale University Julie Livingston, Rutgers University Eric M. Meslin, Indiana University School of Medicine and Indiana University-Purdue University Indianapolis Susan E. Morgan, Purdue University Nancy Scheper-Hughes, University of California, Berkeley Rosamond Rhodes, Mount Sinai School of Medicine and The Graduate Center, City University of New York Carolyn Rouse, Princeton University Karen Salmon, New England School of Law Lesley Sharp, Barnard and Columbia University Mailman School of Public Health Lisa Volk Chewning, Rutgers University Keith Wailoo, Rutgers University

Combining attention to lived experience with the critical tools of ethics, Karey Harwood explores why many women who use high-tech assisted reproduction methods tend to use them repeatedly, even when the results are unsuccessful. With a compassionate look at the individual decision making behind the desire to become pregnant and the use of assisted reproductive technologies (ART), Harwood extends the public conversation beyond debates about individual choice by considering the experiences of families and by addressing the broader ethical problems presented by these technologies. Incorporating the personal narratives of women who are members of RESOLVE, the nation's leading organization for people who are infertile, Harwood demonstrates that repeated unsuccessful attempts to use ART may ironically help women come to terms with their infertility. Yet ART is problematic for a number of reasons, including the financial, physical, and emotional costs for women and their families as well as the effects of these technologies on the health and well-being of the children conceived. Issues such as consumerism, workplace norms that encourage delayed childbearing, and narrow definitions of family all come into play. By considering both emotional and ethical dimensions, Harwood offers a humanistic account of infertility and its resolution in a twenty-first-century American context.

Advocates of rapid access to medicines and critics fearful of inadequate testing both argue that globalization will supersede national medical practices and result in the easy transfer of pharmaceuticals around the world. In "Pharmacopolitics," Arthur Daemmrich challenges their assumptions by comparing drug laws, clinical trials, and systems for monitoring adverse reactions in the United States and Germany, two countries with similarly advanced systems for medical research, testing, and patient care. Daemmrich proposes that divergent "therapeutic cultures"—the interrelationships among governments, patients, the medical profession, and the pharmaceutical industry—underlie national differences and explain variations in pharmaceutical markets and medical care. Daemmrich carries the United States-Germany comparison from 1950 to the present through case studies of Terramycin (an antibiotic), thalidomide (a sedative), propranolol (a heart medication), interleukin-2 (a cancer therapy), and indinavir (an AIDS drug). He points to different political constructions of "the patient" in the United States and Germany to clarify important differences in government policies and in the distribution of power among key social actors. Daemmrich advises that international regulatory harmonization and globalization in medicine must retain flexibility for social and political variation between countries, even as they achieve technical standardization.

Every day, thousands of people quietly face decisions as agonizing as those made famous in the Terri Schiavo case. Throughout that controversy, all kinds of people—politicians, religious leaders, legal and medical experts—made emphatic statements about the facts and offered even more certain opinions about what should be done. To many, courts were either ordering Terri's death by starvation or vindicating her constitutional rights. Both sides called for simple answers. If That Ever Happens to Me details why these simple answers were not right for Terri Schiavo and why they are not right for end-of-life decisions today.Lois Shepherd looks behind labels like "starvation," "care," or "medical treatment" to consider what care and feeding really mean, when feeding tubes might be removed, and why disability groups, the faithful, and even the dying themselves often suggest end-of-life solutions that they might later regret. For example, Shepherd cautions against living wil

Offering a new perspective on medical progress in the nineteenth century, Steven M. Stowe provides an in-depth study of the midcentury culture of everyday medicine in the South. Reading deeply in the personal letters, daybooks, diaries, bedside notes, and published writings of doctors, Stowe illuminates an entire world of sickness and remedy, suffering and hope, and the deep ties between medicine and regional culture. In a distinct American region where climate, race and slavery, and assumptions about "southernness" profoundly shaped illness and healing in the lives of ordinary people, Stowe argues that southern doctors inhabited a world of skills, medicines, and ideas about sickness that allowed them to play moral, as well as practical, roles in their communities. Looking closely at medical education, bedside encounters, and medicine's larger social aims, he describes a "country orthodoxy" of local, social medical practice that highly valued the "art" of medicine. While not modern in the sense of laboratory science a century later, this country orthodoxy was in its own way modern, Stowe argues, providing a style of caregiving deeply rooted in individual experience, moral values, and a consciousness of place and time.

German-born Marie Zakrzewska (1829-1902) was one of the most prominent female physicians of nineteenth-century America. Best known for creating a modern hospital and medical education program for women, Zakrzewska battled against the gendering of science and the restrictive definitions of her sex. In Science Has No Sex, Arleen Tuchman examines the life and work of a woman who continues to challenge historians of gender to this day. At a time when most women physicians laid claim to "female" qualities of care and nurturance to justify their professional choice, Zakrzewska insisted that all physicians, regardless of gender, should depend upon the rational faculties developed through training in the natural sciences. She viewed science as a democratizing tool—anyone could master science, she asserted, and therefore the doors to the elite profession of medicine should be opened to all. Shedding light on the changes that radically transformed medicine in the late nineteenth century, Tuchman's analysis also demonstrates how Zakrzewska's activism is important to the ongoing debate over the relationship between science and sex.

In this collection of essays, Lawrence O. Gostin, an internationally recognized scholar of AIDS law and policy, confronts the most pressing and controversial issues surrounding AIDS in America and around the world. He shows how HIV/AIDS affects the entire population—infected and uninfected—by influencing our social norms, our economy, and our country's role as a world leader. Now in the third decade of this pandemic, the nation and the world still fail to respond to the needs of persons living with HIV/AIDS and continue to tolerate injustice in their treatment, Gostin argues. AIDS, both in the United States and globally, deeply affects poor and marginalized populations, and many U.S. policies are based on conservative moral values rather than public health and social justice concerns. Gostin tackles the hard social, legal, political, and ethical issues of the HIV/AIDS privacy and discrimination, travel and immigration, clinical trials and drug pricing, exclusion of HIV-infected health care workers, testing and treatment of pregnant women and infants, and needle-exchange programs. This book provides an inside account of AIDS policy debates together with incisive commentary. It is indispensable reading for advocates, scholars, health professionals, lawyers, and the concerned public.

The need for informed analyses of health policy is now greater than ever. The twelve essays in this volume show that public debates routinely bypass complex ethical, sociocultural, historical, and political questions about how we should address ideals of justice and equality in health care. Integrating perspectives from the humanities, social sciences, medicine, and public health, this volume illuminates the relationships between justice and health inequalities to enrich debates. Understanding Health Inequalities and Justice explores three questions: How do scholars approach relations between health inequalities and ideals of justice? When do justice considerations inform solutions to health inequalities, and how do specific health inequalities affect perceptions of injustice? And how can diverse scholarly approaches contribute to better health policy? From addressing patient agency in an inequitable health care environment to examining how scholars of social justice and health care amass evidence, this volume promotes a richer understanding of health and justice and how to achieve both. The contributors are Judith C. Barker, Paula Braveman, Paul Brodwin, Jami Suki Chang, Debra DeBruin, Leslie A. Dubbin, Sarah Horton, Carla C. Keirns, J. Paul Kelleher, Nicholas B. King, Eva Feder Kittay, Joan Liaschenko, Anne Drapkin Lyerly, Mary Faith Marshall, Carolyn Moxley Rouse, Jennifer Prah Ruger, and Janet K. Shim.

Since the introduction of Medicare and Medicaid in 1965, the American health care system has steadily grown in size and complexity. Muriel R. Gillick takes readers on a narrative tour of American health care, incorporating the stories of older patients as they travel from the doctor's office to the hospital to the skilled nursing facility, and examining the influence of forces as diverse as pharmaceutical corporations, device manufacturers, and health insurance companies on their experience. A scholar who has practiced medicine for over thirty years, Gillick offers readers an informed and straightforward view of health care from the ground up, revealing that many crucial medical decisions are based not on what is best for the patient but rather on outside forces, sometimes to the detriment of patient health and quality of life. Gillick suggests a broadly imagined patient-centered reform of the health care system with Medicare as the engine of change, a transformation that would be mediated through accountability, cost-effectiveness, and culture change.

The 1954 Brown v. Board of Education decision required desegregation of America's schools, but it also set in motion an agonizing multidecade debate over race, class, and IQ. In this innovative book, Michael E. Staub investigates neuropsychological studies published between Brown and the controversial 1994 book The Bell Curve. In doing so, he illuminates how we came to view race and intelligence today.In tracing how research and experiments around such concepts as learned helplessness, deferred gratification, hyperactivity, and emotional intelligence migrated into popular culture and government policy, Staub reveals long-standing and widespread dissatisfaction—not least among middle-class whites—with the metric of IQ. He also documents the devastating consequences—above all for disadvantaged children of color—as efforts to undo discrimination and create enriched learning environments were recurrently repudiated and defunded. By connecting psychology, race, and public policy in a single narrative, Staub charts the paradoxes that have emerged and that continue to structure investigations of racism even into the era of contemporary neuroscientific research.

Over the last twenty years, type 2 diabetes skyrocketed to the forefront of global public health concern. In this book, Mari Armstrong-Hough examines the rise in and response to the disease in two the United States and Japan. Both societies have faced rising rates of diabetes, but their social and biomedical responses to its ascendance have diverged. To explain the emergence of these distinctive strategies, Armstrong-Hough argues that physicians act not only on increasingly globalized professional standards but also on local knowledge, explanatory models, and cultural toolkits. As a result, strategies for clinical management diverge sharply from one country to another. Armstrong-Hough demonstrates how distinctive practices endure in the midst of intensifying biomedicalization, both on the part of patients and on the part of physicians, and how these differences grow from broader cultural narratives about diabetes in each setting.

In the late nineteenth century, as Americans debated the "woman question," a battle over the meaning of biology arose in the medical profession. Some medical men claimed that women were naturally weak, that education would make them physically ill, and that women physicians endangered the profession. Mary Putnam Jacobi (1842-1906), a physician from New York, worked to prove them wrong and argued that social restrictions, not biology, threatened female health. Mary Putnam Jacobi and the Politics of Medicine in Nineteenth-Century America is the first full-length biography of Mary Putnam Jacobi, the most significant woman physician of her era and an outspoken advocate for women's rights. Jacobi rose to national prominence in the 1870s and went on to practice medicine, teach, and conduct research for over three decades. She campaigned for co-education, professional opportunities, labor reform, and suffrage—the most important women's rights issues of her day. Downplaying gender differences, she used the laboratory to prove that women were biologically capable of working, learning, and voting. Science, she believed, held the key to promoting and producing gender equality. Carla Bittel's biography of Jacobi offers a piercing view of the role of science in nineteenth-century women's rights movements and provides historical perspective on continuing debates about gender and science today.

In the early 1970s, a new wave of public service announcements urged parents to “help end an American tradition” of child abuse. The message, relayed repeatedly over television and radio, urged abusive parents to seek help. Support groups for parents, including Parents Anonymous, proliferated across the country to deal with the seemingly burgeoning crisis. At the same time, an ever-increasing number of abused children were reported to child welfare agencies, due in part to an expansion of mandatory reporting laws and the creation of reporting hotlines across the nation. Here, Mical Raz examines this history of child abuse policy and charts how it changed since the late 1960s, specifically taking into account the frequency with which agencies removed African American children from their homes and placed them in foster care. Highlighting the rise of Parents Anonymous and connecting their activism to the sexual abuse moral panic that swept the country in the 1980s, Raz argues that these panics and policies—as well as biased viewpoints regarding race, class, and gender—played a powerful role shaping perceptions of child abuse. These perceptions were often directly at odds with the available data and disproportionately targeted poor African American families above others.