Prior to the nineteenth century, the practice of medicine in the Western world was as much art as science. But, argues W. F. Bynum, 'modern' medicine as practiced today is built upon foundations that were firmly established between 1800 and the beginning of World War I. He demonstrates this in terms of concepts, institutions, and professional structures that evolved during this crucial period, applying both a more traditional intellectual approach to the subject and the newer social perspectives developed by recent historians of science and medicine. In a wide-ranging survey, Bynum examines the parallel development of biomedical sciences such as physiology, pathology, bacteriology, and immunology, and of clinical practice and preventive medicine in nineteenth-century Europe and North America. Focusing on medicine in the hospitals, the community, and the laboratory, Bynum contends that the impact of science was more striking on the public face of medicine and the diagnostic skills of doctors than it was on their actual therapeutic capacities.

"Although physicians make use of science, this book argues that medicine is not itself a science, but rather an interpretive practice that relies heavily on clinical reasoning." "In How Doctors Think, Kathryn Montgomery contends that assuming medicine is strictly a science can have adverse effects. She suggests these can be significantly reduced by recognizing the vital role of clinical judgment."--BOOK JACKET.

The book - which includes essays by physicians, philosophers, and a nurse - is divided into three parts: one deals with how empathy is weakened or lost during the course of medical education and suggests how to remedy this; another describes the historical and philosophical origins of empathy and provides arguments for and against it; and a third section offers compelling accounts of how physicians' empathy for their patients has affected their own lives and the lives of those in their care. We hear, for example, from a physician working in a hospice who relates the ways that the staff try to listen and respond to the needs of the dying; a scientist who interviews candidates for medical school and tells how qualities of empathy are undervalued by selection committees; a nurse who considers what nursing can teach physicians about empathy; another physician who ponders whether the desire to be empathic can hinder the detachment necessary for objective care; and several contributors who show how literature and art can help physicians to develop empathy.

Completely rewritten by the internal medicine faculty as Johns Hopkins, this is a brand-new version of Harvey's classic book.

This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.

The second edition of this innovative work again provides a unique perspective on the clinical discovery process by providing input from experts within the NIH on the principles and practice of clinical research. Molecular medicine, genomics, and proteomics have opened vast opportunities for translation of basic science observations to the bedside through clinical research. As an introductory reference it gives clinical investigators in all fields an awareness of the tools required to ensure research protocols are well designed and comply with the rigorous regulatory requirements necessary to maximize the safety of research subjects. Complete with sections on the history of clinical research and ethics, copious figures and charts, and sample documents it serves as an excellent companion text for any course on clinical research and as a must-have reference for seasoned researchers.*Incorporates new chapters on Managing Conflicts of Interest in Human Subjects Research, Clinical Research from the Patient's Perspective, The Clinical Researcher and the Media, Data Management in Clinical Research, Evaluation of a Protocol Budget, Clinical Research from the Industry Perspective, and Genetics in Clinical Research *Addresses the vast opportunities for translation of basic science observations to the bedside through clinical research*Delves into data management and addresses how to collect data and use it for discovery*Contains valuable, up-to-date information on how to obtain funding from the federal government

Collaborations of physicians and researchers with industry can provide valuable benefits to society, particularly in the translation of basic scientific discoveries to new therapies and products. Recent reports and news stories have, however, documented disturbing examples of relationships and practices that put at risk the integrity of medical research, the objectivity of professional education, the quality of patient care, the soundness of clinical practice guidelines, and the public's trust in medicine. Conflict of Interest in Medical Research, Education, and Practice provides a comprehensive look at conflict of interest in medicine. It offers principles to inform the design of policies to identify, limit, and manage conflicts of interest without damaging constructive collaboration with industry. It calls for both short-term actions and long-term commitments by institutions and individuals, including leaders of academic medical centers, professional societies, patient advocacy groups, government agencies, and drug, device, and pharmaceutical companies. Failure of the medical community to take convincing action on conflicts of interest invites additional legislative or regulatory measures that may be overly broad or unduly burdensome. Conflict of Interest in Medical Research, Education, and Practice makes several recommendations for strengthening conflict of interest policies and curbing relationships that create risks with little benefit. The book will serve as an invaluable resource for individuals and organizations committed to high ethical standards in all realms of medicine.

2009 life science book award from IAA.

The spectrum of addiction disorders presents practitioners with numerous challenges—among them the widening gap between a growing evidence base and the translation of this knowledge into treatment outcomes. Addiction Medicine addresses this disconnect, clearly explaining the role of brain function in drug taking and other habit-forming behaviors, and applying this biobehavioral framework to the delivery of evidence-based treatment. Its state-of-the-art coverage provides clinically relevant details on not only traditional sources of addiction such as cocaine, opiates, and alcohol, but also more recently recognized substances of abuse (e.g., steroids, inhalants) as well as behavioral addictions (e.g., binge eating, compulsive gambling, hoarding). Current behavioral and medical therapies are discussed in depth, and the book’s close attention to social context gives readers an added lens for personalizing treatment. An international panel of expert contributors offers the most up-to-date information on: Diagnosis and classification Neurobiological and molecular theories of addiction Behavioral concepts of addiction Clinical aspects of addiction to a wide range of substances, including opiates, stimulants, sedatives, hallucinogens, alcohol, nicotine, and caffeine Science-based treatment options: pharmacotherapy, pharmacogenetics, potential vaccines, brief and compliance-enhancing interventions, cognitive behavioral treatment, behavioral management, and other psychosocial interventions Behavioral addictions—including compulsive eating, Internet messaging, and hypersexuality—and their treatment Addiction in specific populations, including adolescents, the elderly, pregnant women, and health care professionals Legal, disability, and rehabilitation issues At once comprehensive and integrative, Addiction Medicine is an essential text and a practice-expanding tool for psychiatrists, health psychologists, pharmacologists, social workers, drug counselors, trainees, and general physicians/family practitioners.

In the realm of health care, privacy protections are needed to preserve patients' dignity and prevent possible harms. Ten years ago, to address these concerns as well as set guidelines for ethical health research, Congress called for a set of federal standards now known as the HIPAA Privacy Rule. In its 2009 report, Beyond the HIPAA Privacy Rule: Enhancing Privacy, Improving Health Through Research, the Institute of Medicine's Committee on Health Research and the Privacy of Health Information concludes that the HIPAA Privacy Rule does not protect privacy as well as it should, and that it impedes important health research.