Strangers at the Bedside: A History of How Law and Bioethics Transformed Medical Decision Making (Social Institutions and Social Change Series) - Softcover

Softcover

ISBN 10: 0202307255 ISBN 13: 9780202307251

Publisher: Aldine Transaction, 1994

Synopsis

David Rothman gives us a brilliant, finely etched study of medical practice today. Beginning in the mid-1960s, the practice of medicine in the United States underwent a most remarkable--and thoroughly controversial--transformation. The discretion that the profession once enjoyed has been increasingly circumscribed, and now an almost bewildering number of parties and procedures participate in medical decision making.

Well into the post-World War II period, decisions at the bedside were the almost exclusive concern of the individual physician, even when they raised fundamental ethical and social issues. It was mainly doctors who wrote and read about the morality of withholding a course of antibiotics and letting pneumonia serve as the old man's best friend, of considering a newborn with grave birth defects a "stillbirth" thus sparing the parents the agony of choice and the burden of care, of experimenting on the institutionalized the retarded to learn more about hepatitis, or of giving one patient and not another access to the iron lung when the machine was in short supply. Moreover, it was usually the individual physician who decided these matters without formal discussions with patients, their families, or even with colleagues, and certainly without drawing the attention of journalists, judges, or professional philosophers.

The impact of the invasion of outsiders into medical decision-making, most generally framed, was to make the invisible visible. Outsiders to medicine--that is, lawyers, judges, legislators, and academics--have penetrated its every nook and cranny, in the process giving medicine exceptional prominence on the public agenda and making it the subject of popular discourse. The glare of the spotlight transformed medical decision making, shaping not merely the external conditions under which medicine would be practiced (something that the state, through the regulation of licensure, had always done), but the very substance of medical practice--the decisions that physicians made at the bedside.

About this title

About the Author:

David J. Rothman is Bernard Schoenberg Professor of Social Medicine, professor of history, and director of the Center for the Study of Science and Medicine at the College of Physicians and Surgeons, Columbia University.  He is the author of numerous works, including The Willowbrook Wars, The Discovery of the Asylum, and The Pursuit of Perfection: The Promise and Perils of Medical Enhancement.

Review:

"For anyone wishing to become acquainted with this field, I would recommend reading [Strangers at the Bedside] for a situated, historical account."

—Kathryn Ehrich, Medical Sociology News

"Rothman has written an informative and insightful account of how American medicine has been transformed over the past twenty-five years. . . . He gives a masterful outline of academic bioethics, one of the primary sources of transformation. His discussion of certain key issues -- the availability of kidney dialysis machines, transplantation, and the wrenching decisions about sick newborns -- is particularly good. . . . [Strangers at the Bedside] is recommended to anyone seeking to understand how bioethics and the law have become so important in research and clinical medicine in American society today." 

—Stephen E. Lammers, The Journal of Interdisciplinary History

"Rothman's book is an exciting intellectual history." 

—Charles L. Bosk, Contemporary Sociology

"Rothman illuminates a major transformation in American medicine. . . . This is an important book that deserves wide readership."

—Ronald L. Numbers, The American Historical Review

"The landscape of biomedical research and clinical medicine has changed dramatically in the past twenty-five years. Professor David J. Rothman. . . chronicles this change in a well-written and thoughtful book that should be read by anyone who is concerned about the evolving relatioship between medical researchers and their subjects or between doctors and their patients."

—Greg Gramelspacher, The Journal of American History

"[Rothman's] book is a fascinating effort chronicling recent changes in medical practice in the United States."

—Susan McIntosh, History and Philosophy of the Life Sciences 

"David Rothman's challenging new book is essential reading for understanding the transformation in public and professional attitudes that recast medical decision making and launched the new discipline of bioethics. . . . Although the current throng of outsiders in a patient's room may well be a transitional stage in the history of relations between doctors and patients, this work will surely enjoy a more lasting place in the historiography of twentieth-century medicine." 

—Susan E. Lederer, Isis

About this edition

• Publisher: Aldine Transaction
• Publication date: 1994
• ISBN 10: 0202307255
• ISBN 13: 9780202307251
• Binding: Paperback
• Number of pages: 326
• Editor: Rothman David J.