A skillful, subtle exploration of the assumptions which guide contemporary thinking in medicine, this offers in place of the...

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MEDICAL CHOICES, MEDICAL CHANCES: How Patients, Families and Physicians Can Cope with Uncertainty

A skillful, subtle exploration of the assumptions which guide contemporary thinking in medicine, this offers in place of the outmoded mechanistic model a far more workable probabilistic framework. The four authors contend that medicine should adopt the paradigm shift of modern physics, that physicians and patients, sharing responsbility, can alter their expectations, learn to look for changing configurations of causes, and include in the decision process factors formerly considered irrelevant or ""unscientific""--a patient's feelings about entering the hospital, for example, or the advisability of a diagnostic test which confirms an untreatable disease. A fictional Dr. S. is used to represent probabilistic medical thinking, and although he's more appealing than your own family doctor (making house calls to the severely ill, guarding against automatic responses, admitting professional discomfort and even occasional lapses), he's not too good to be true. Moreover, the cases he confronts have not been simplified: they represent the complex ""gambles"" a family doctor faces. Other books criticizing the medical model fail to take fully into account the pervasiveness of mechanistic ways of thinking or the tangle of motive and behavior in a profit-centered society; here those formidable difficulties are insisted upon, and examined each time they arise. Can it work? Can we really change such entrenched attitudes and behaviors? Not immediately, Dr. S. believes, but maybe in time, and medicine is in a position to start now. Like Cousins' Anatomy of an Illness (1979), this opposes ""the bias. . . toward expensive profitable technology"" and the loss of personal care that characterize medical treatment today. By presenting the doctor's side as well--including the need for a night's sleep or compensation for ""unbillable"" time--this makes an even stronger case for restructuring the doctor/patient relationship and revising its philosophical moorings.

Pub Date: Feb. 26, 1980

ISBN: N/A

Page Count: -

Publisher: Delacorte

Review Posted Online: N/A

Kirkus Reviews Issue: Feb. 1, 1980