When we're ill, we trust in doctors to put our well-being first. But medicine's expanding capability and soaring costs are putting this promise at risk. Increasingly, society is calling upon physicians to limit care and to use their skills on behalf of health plan bureaucrats, public officials, national security, and courts of law. And doctors are answering this call. They're endangering patients, veiling moral choices behind the language of science and, at times, compromising our liberties. In The Hippocratic Myth, Dr. M. Gregg Bloche marshals his expertise in medicine and the law to expose how:
*Doctors are pushed into acting both as caregivers and cost-cutters, compromising their fidelity to patients
*Politics keeps doctors from giving war veterans the help they need
*Insurers and hospital administrators pressure doctors to discontinue life-saving treatment, even when patients and family members object
*Medicine has become a weapon in America's battles over abortion, child custody, criminal responsibility, and the rights of gays and lesbians
*The war on terror has exploited clinical psychology to inflict harm
Challenging, provocative, and insightful, The Hippocratic Myth breaks the code of silence and issues a powerful warning about the need for doctors to forge a new compact with patients and society.
Bloche doesn't balk when it comes to laying it on the line. He gives readers the bleak news: insurers have the right to "pick and choose medical opinions," regardless of need, which puts doctors in an increasingly difficult position. In Bloche's first book, doctors are political animals (he argues that "diagnosis...is a political act") and moral questions abound. As doctors increasingly enter courtrooms to help determine child custody cases or mental competency, practitioners are also "moral arbiters and enforcers." And a "Doctors as Warriors" section offers a fascinating profile of "new" medical professionals but is dense enough to lose casual readers. Bloche's case studies, however, are particularly effective: a patient decides to stop dialysis knowing that it will result in her certain death; a soldier with "classic symptoms of PTSD" struggles to find coverage and competent care. What Bloche makes terribly clear is that the crisis we face encompasses medical care, coverage, and cost. He deserves kudos for taking on such disheartening, pressing subjects, for asking tough questions, and for finally offering dramatic reforms. This is a valuable look at the world of medicine.