cover image Ordinary Medicine: Extraordinary Treatments, Longer Lives, and Where to Draw the Line

Ordinary Medicine: Extraordinary Treatments, Longer Lives, and Where to Draw the Line

Sharon R. Kaufman. Duke Univ, $26.95 (336p) ISBN 978-0-8223-5888-6

Medical anthropologist Kaufman bravely delves into the heartbreaking predicament of modern medicine: “getting the medicine we wish for but then having to live with the unsettling and far-ranging consequences.” She argues that the “drivers” governing medicine are the biomedical research industry and its clinical trials, Medicare and insurance decisions on what gets reimbursed, the determination of a “standard of care,” and the intractability of those standards—all of which are typically profit-driven factors that have set the bar for what is considered routine or taken for granted. Yet this “ordinary medicine” doesn’t help patients or doctors make the hard choices on when to stop treatments, Kaufman worries. For example, she writes, the implantable cardiac defibrillator (ICD) is being used as a primary prevention device for a sudden heart attack despite a lack of evidence for its widespread necessity. Kaufman is at her best when focusing on the heartbreaking dilemma of patients dealing with the consequences of ordinary medicine, such as an elderly patient who must choose between lifesaving treatments or palliative care, facing repeated hospital visits regardless of the choice. Kaufman calls for no less than making the ethics of medicine the “preeminent topic of our national conversation about health care reform.” [em](June) [/em]