cover image Intensive Care: Medical Ethics and the Medical Profession

Intensive Care: Medical Ethics and the Medical Profession

Robert Zussman. University of Chicago Press, $34.5 (260pp) ISBN 978-0-226-99634-9

Zussman notes that the patients' rights movement emerged out of the technical orientation of contemporary medicine and the attendant impersonality of the doctor-patient relationship. He shows this situation forcefully and in all its complexity as he reports on the two years (1985-1987) he spent observing in the 14-bed intensive care unit at ``Outerboro'' (a New York City teaching hospital that treats primarily the poor, blacks and Hispanics) and the 22-bed ICU at ``Countryside'' (a teaching hospital in a middle-class suburb of Boston), where he spent 1989. His clinical detachment as he writes of the unnerving goings-on at the ICU will be reassuring to queasy readers, for alongside his accounts of medical procedures he depicts patients denied their personhood by their disabilities and the staff's view of them not as full people but as physiology experiments whose care is a puzzle to be solved. Ignoring costs and disregarding a patient's social worth and age, the ICU's primary criterion in triage, Zussman claims, is technical: is treatment futile? In the culture of the new medicine, Zussman, a sociologist at the State University of New York, concludes (perhaps wistfully) that ``Triage . . . requires the substitution of a utilitarian ethic for Hippocratic individualism.'' Although written for professionals, this research paper has wide application for general readers. (Aug.)