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

337 Pages·2015·1.29 MB·English

by  Sharon R Kaufman

PRAISE FOR ORDINARY MEDICINE
“I devoured Ordinary Medicine. It gave me courage. It helped
me delineate, sometimes for the frst time, the interlocking
forces and practices that have helped create an epidemic of
unnecessary sufering at the end of life. Breathtaking in its
scope, rigor, and intellectual range, this book will help read-
ers take back control of their lives and deaths from the forces
that have created an ‘ordinary’ end-of-life medicine that is far
from ordinary.”
—KATY BUTLER, author of Knocking on Heaven’s Door:
The Path to a Better Way of Death
“The recommendation by the ama to Medicare to begin pay-
ing physicians for discussions with patients about end-of-life
care makes this new book by Sharon R. Kaufman particularly
timely. She explains why the present health care system is bi-
ased toward excess treatment at the end of life and advocates
a broad approach to health care reforms that goes beyond cost
control to encompass social and ethical considerations.”
—VICTOR R. FUCHS, author of Who Shall Live? Health,
Economics and Social Choice
“Sharon R. Kaufman has made an important and disturbing
discovery about the links between for-proft healthcare com-
panies, so-called evidence-based medicine, doctors, and pa-
tients. Ordinary Medicine should be read, thought about, and
acted upon by those who have the power to efect change.”
—VICTORIA SWEET, author of God’s Hotel: A Doctor, a Hospital,
and a Pilgrimage to the Heart of Medicine
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ORDINARY MEDICINE
Critical Global Health: Evidence, Efcacy, Ethnography
Edited by Vincanne Adams and João Biehl
ORDINARY
MEDICINE
Extraordinary Treatments, Longer Lives,
and Where to Draw the Line
SHARON R. KAUFMAN
Duke university Press Durham & London 2015
© 2015 Duke University Press
All rights reserved
Printed in the United States of America
on acid-f ree paper ∞
Typeset in Scala by Westchester Book Group
Library of Congress Cataloging-in-Publication Data
Kaufman, Sharon R.
Ordinary medicine : extraordinary treatments,
longer lives, and where to draw the line / Sharon
R. Kaufman
pages cm—(Critical global health)
Includes bibliographical references and index.
isbn 978-0-8223-5902-9 (hardcover : alk. paper)
isbn 978-0-8223-5888-6 (pbk. : alk. paper)
isbn 978-0-8223-7550-0 (e-book)
1. Medical care—United States. 2. Medical
e thics—United States. 3. Medical care, Cost of—
United States. 4. Longevity—United States.
i. Title. ii. Series: Critical global health.
ra395.a3k385 2015
362.10973—dc23
2014043465
Cover art: ERproductions Ltd. / Getty Images
To the memory of
my father,
Bernard Kaufman Jr., mD,
1914–2008,
and to
Gay Becker,
colleague, friend,
1943–2007
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CONTENTS
Ack nowl edgm ents . ix
Introduction
Diagnosing Twenty-F irst-C entury Health Care . 1
PART I: THE QUANDARY AND UNEXAMINED
ORDINARINESS OF TWENTY- FIRST-C ENTURY MEDICINE
1. Ordinary Medicine in Our Aging Society
The Dilemma of Longevity . 21
PART II: THE CHAIN OF HEALTH CARE DRIVERS
2. The Medical-I ndustrial Complex I
Evidence-B ased Medicine, the Biomedical Economy,
and the Ascendance of Clinical Trials . 53
3. The Medical-I ndustrial Complex II
Access, Industry, and the Clinical Trials
Phenomenon . 79
4. “Reimbursement Is Critical for Everything”
Medicare and the Ethics of Managing Life . 9 9
PART III: MEDICINE’S CHANGING MEANS AND ENDS
5. Standard and Necessary Treatments
The Changing Means and Ends of Technology . 1 27
6. Family Matters
Kidneys and New Forms of Care . 165