Product Description

As the future of the private doctor/patient relationship comes into question, Do We Still Need Doctors? offers an intimate look at doctors' shifting roles and responsibilities in our rapidly changing health care system. Now in paperback, this poignant and compassionate personal account, which has received widespread media attention, including Oprah, offers an intimate look at how today's doctors are dealing with the ethical and political battles that are reshaping our nation's health care system.

Weaving affecting stories of his young patients with stirring dilemmas of truth telling, creative negotiation of HMO bureaucracy, and reflections on the identity crisis of medical education, pediatrician Dr. Lantos-a member of the Clinton Administration's Presidential Task Force on Health Care Reform-reveals how changes in our health care system and technological advances are fostering new ways of understanding and responding to illness. He taps into the public's dissatisfaction with the current role doctors and hospitals play in patient care and presents balanced views of both managed care and for-profit medicine. Most importantly, Dr. Lantos reveals how managed care continues a trend toward rationalizing disease and streamlining treatment that doctors themselves have initiated and sustained for decades. Illness and death will always resist rationalizing, and in order to respond to them, he claims doctors and patients alike need to re-imagine what healing is or ought to be.

Product Details

• Amazon Sales Rank: #415246 in Books
• Published on: 1999-10
• Original language: English
• Number of items: 1
• Binding: Paperback
• 214 pages

From Library Journal
For better or worse, argues Lantos, society "has constructed a legal and ethical framework around the medical care system that reinforces the social values we hold dear." A pediatrician, teacher, and bioethicist at the University of Chicago, Lantos reveals how we have created "moral gridlock" in which the private lives of patients are often controlled by professionals and other government strangers in the full public view given by the media and the law. As a result, medicine itself has, ironically, come to be perceived as the problem in need of a solution. In today's medicine, the traditional emotional and spiritual qualities of the doctor-patient relationship are often overridden by larger social and economic issues to the extent that one can actually ask whether the doctor is still necessary. With intelligence and balance, Lantos guides the reader through the ethical morass of what has become a public debate. Highly recommended for academic and larger public libraries.?James Swanton, Harlem Hosp. Lib., New York
Copyright 1997 Reed Business Information, Inc.

From Booklist
Pediatrician and bioethicist Lantos takes a hard look at what doctors currently do and what they might be doing and examines which of those activities others could do as well or better. He scrutinizes current problems and misconceptions. What does the much higher CPR success rate of TV doctors compared to real doctors do to our expectations? Did we ever have a good-old-days doctor-patient relationship? Why does medicine nowadays play down prevention and teaching to emphasize curing and research? Should the doctor always tell a patient the truth? When a doctor makes a mistake, what should happen and to whom? Lantos asks a lot of questions but gives few answers, for he wants doctors and patients to apply their own reasoning to find answers. Properly read, the book is hard work, but readers stand to learn much. If it just makes many uncomfortable, it will have achieved Lantos' goal. William Beatty

From Kirkus Reviews
The title's challenging question is only one of the many posed in this wide-ranging examination of doctors and the practice of medicine. Lantos, a physician who describes himself as a professional moralist, is asking how recent developments in the delivery of health care change ``what we should think about the proper response to illness and suffering, how we should train the people whom we empower to respond, and how we should shape the institutions that educate those people and deliver those services.'' To explore these questions, Lantos, a bioethicist at the University of Chicago and pediatrician in a hospital for chronically ill children, tells troubling stories from his own experiences. The role of doctors, says Lantos, has always been partly interventionist (diagnosing and treating) and partly interpretive (understanding and explaining the meaning of illness). The interventionist model, he asserts, has won out. The essence of modern medical practice is alienation, disengagement, and ``a weird equanimity in the face of horrific disease.'' Yet while we insist on the physician as scientist, we still yearn in our hearts for the old humanistic model of physician as shaman/healer. Lantos questions whether a single profession can contain these contradictory notions. We may, he says, be witnessing the creation of a new profession ``driven by science, technology, reductionist ethics, and entitlement economics.'' He is not optimistic about the future of medicine, questioning whether some core of morality or belief will persist underneath the transformations that are taking place. Fiction provides some of the most imaginative responses to the question of what we want doctors to be and do, says Lantos, and he concludes by turning to authors Robertson Davies and Walker Percy, among others, for visions of the challenges facing doctors. A disturbing, often painful examination of a profession in transition. (Author tour) -- Copyright ©1997, Kirkus Associates, LP. All rights reserved.

Customer Reviews

Actually...
Actually, it was quite good. I read this one while on a Hawaiian vacation and still managed to knock it out in under ten days. Sure, Dr. Lantos draws generously on personal anecdotes, but medical ethics is a topic that lends itself perfectly to first-person discussion. I am a paramedic who works under the authority of a medical-control physician. I know first-hand that while we like to kid ourselves into thinking that medicine is scientific, the fact is that to a large degree it remains a highly subjective, opinionated, and often contentious application of scientific principles. What's the joke about "ask ten doctors and you'll get ten different opinions?" This certainly holds true for medical ethics as well. So, Dr. Lantos should speak from experience. Any other approach to the topic would be disingenuous. He discusses dilemmas not unlike those which prehospital practitioners encounter in the street. For example, what do you do when you arrive at the home of a hospice patient in cardiac arrest? The issue isn't quite so clear when the patient's family is at the scene demanding you leave the patient alone. What if they tell you there is a Do Not Resuscitate Order from the primary-care physician, only, they cannot produce the actual signed document for you right then and there? It can pretty awkward, and ugly. I found Dr. Lantos' book reminded me of some of those very same quandaries, and even pointed out new ones I'd never thought of before. I found the discussion fascinating.

Medicine and philosophy
We do still need doctors, of course, and will probably need them far into the future. What John Lantos really explores is what role will they play? What role do they play now? What is their relation to the patient? How should they be trained? What decisions should they make? Is it right for us to spend so many resources on a few patients who want expensive operations when for the same cost, we could promote the public health of hundreds, perhaps thousands?

Through examples, Lantos shows the reader how difficult some choices in the medical world are. Often, there is no right answer, and sometimes all the answers seem wrong. Though he does speak his opinions, he rarely gives an answer to the problems he displays because there are no true answers. The examples he gives come from his own personal experiences, stories published in journals or discussed in forums, and some of the most interesting examples are fictional, from literary works. The ethical dilemmas he presents are interesting to think about in their own right, but they may also have a practical value in that you may have to face one of these situations at some point in time if not already.

If we really want to change the way health care is performed in America, we have to think about what we want from our doctors and how we want to be treated for diseases and conditions. We have to think about the dilemmas that doctors face, and those that patients face, as well as the decisions that family members may have to make. We have to understand that there are many parties that have different interests arguing different things. We may never know exactly what the right things to do are, but shouldn�t we at least wonder?

A true Classic
As I read the first reveiw of this book, I was shocked and appalled at the distinct lack of intelegence displayed by the reviewer. In fact, the only thing that is not worth reading is his review! In reality this is one of the most interesting and enlightening books on medical ethics ever written. Lantos's first person experiences truely bring medical ethics to a personal level and give readers a better understanding of the current medical ethics dilemas that currently face all people today. This is a must read book.