Medical Choices, Medical Chances


Book Description

Considered ahead of its time since the first publication in 1981, Medical Choices, Medical Chances provides a telescope for viewing how developments in the fields of medical research, medical technology, and health care organization are likely to influence the doctor-patient relationship in the 21st Century. The book explores this intricate web of relationships among doctors, patients, and families and offers a new framework for mastering the emotional and intellectual challenges of uncertainty, while at the same time providing tools for all concerned to regain control from managed care. It is a must-read for all those interested in medicine and where it is headed in the new millennium.




Your Medical Mind


Book Description

Drs. Groopman and Hartzband reveal a clear path for making the right medical choices. Such factors as authority figures, statistics, other patients' stories, technology, and natural healing are key factors that shape choices.




Calculated Risks


Book Description

At the beginning of the twentieth century, H. G. Wells predicted that statistical thinking would be as necessary for citizenship in a technological world as the ability to read and write. But in the twenty-first century, we are often overwhelmed by a baffling array of percentages and probabilities as we try to navigate in a world dominated by statistics. Cognitive scientist Gerd Gigerenzer says that because we haven't learned statistical thinking, we don't understand risk and uncertainty. In order to assess risk -- everything from the risk of an automobile accident to the certainty or uncertainty of some common medical screening tests -- we need a basic understanding of statistics. Astonishingly, doctors and lawyers don't understand risk any better than anyone else. Gigerenzer reports a study in which doctors were told the results of breast cancer screenings and then were asked to explain the risks of contracting breast cancer to a woman who received a positive result from a screening. The actual risk was small because the test gives many false positives. But nearly every physician in the study overstated the risk. Yet many people will have to make important health decisions based on such information and the interpretation of that information by their doctors. Gigerenzer explains that a major obstacle to our understanding of numbers is that we live with an illusion of certainty. Many of us believe that HIV tests, DNA fingerprinting, and the growing number of genetic tests are absolutely certain. But even DNA evidence can produce spurious matches. We cling to our illusion of certainty because the medical industry, insurance companies, investment advisers, and election campaigns have become purveyors of certainty, marketing it like a commodity. To avoid confusion, says Gigerenzer, we should rely on more understandable representations of risk, such as absolute risks. For example, it is said that a mammography screening reduces the risk of breast cancer by 25 percent. But in absolute risks, that means that out of every 1,000 women who do not participate in screening, 4 will die; while out of 1,000 women who do, 3 will die. A 25 percent risk reduction sounds much more significant than a benefit that 1 out of 1,000 women will reap. This eye-opening book explains how we can overcome our ignorance of numbers and better understand the risks we may be taking with our money, our health, and our lives.




Critical Decisions


Book Description

Critical Decisions is the most important book on the patient-doctor relationship to date. In this revolutionary book, practicing physician, behavioural scientist, and bioethicist Peter Ubel reveals how hidden dynamics keep us, and our loved ones, from making the best medical choices.




Medical Choices, Medical Chances


Book Description




Dicing with Death


Book Description

If you think that statistics has nothing to say about what you do or how you could do it better, then you are either wrong or in need of a more interesting job. Stephen Senn explains here how statistics determines many decisions about medical care, from allocating resources for health, to determining which drugs to license, to cause-and-effect in relation to disease. He tackles big themes: clinical trials and the development of medicines, life tables, vaccines and their risks or lack of them, smoking and lung cancer and even the power of prayer. He entertains with puzzles and paradoxes and covers the lives of famous statistical pioneers. By the end of the book the reader will see how reasoning with probability is essential to making rational decisions in medicine, and how and when it can guide us when faced with choices that impact on our health and even life.




Getting Risk Right


Book Description

Do cell phones cause brain cancer? Does BPA threaten our health? How safe are certain dietary supplements, especially those containing exotic herbs or small amounts of toxic substances? Is the HPV vaccine safe? We depend on science and medicine as never before, yet there is widespread misinformation and confusion, amplified by the media, regarding what influences our health. In Getting Risk Right, Geoffrey C. Kabat shows how science works—and sometimes doesn't—and what separates these two very different outcomes. Kabat seeks to help us distinguish between claims that are supported by solid science and those that are the result of poorly designed or misinterpreted studies. By exploring different examples, he explains why certain risks are worth worrying about, while others are not. He emphasizes the variable quality of research in contested areas of health risks, as well as the professional, political, and methodological factors that can distort the research process. Drawing on recent systematic critiques of biomedical research and on insights from behavioral psychology, Getting Risk Right examines factors both internal and external to the science that can influence what results get attention and how questionable results can be used to support a particular narrative concerning an alleged public health threat. In this book, Kabat provides a much-needed antidote to what has been called "an epidemic of false claims."




Smart Health Choices


Book Description

Every day we make decisions about our health - some big and some small. What we eat, how we live and even where we live can affect our health. But how can we be sure that the advice we are given about these important matters is right for us? This book will provide you with the right tools for assessing health advice.




Choose Your Medicine


Book Description

A comprehensive history of the concept of freedom of therapeutic choice in the United States that presents a compelling look at how persistent but evolving notions of a right to therapeutic choice have affected American policy and law from the Revolution through the Trump Era. Throughout American history, lawmakers have limited the range of treatments available to patients, often with the backing of the medical establishment. The country's history is also, however, brimming with social movements that have condemned such restrictions as violations of fundamental American liberties. This fierce conflict is one of the defining features of the social history of medicine in the United States. In Choose Your Medicine, Lewis A. Grossman presents a compelling look at how persistent but evolving notions of a right to therapeutic choice have affected American health policy, law, and regulation from the Revolution through the Trump Era. Grossman grounds his analysis in historical examples ranging from unschooled supporters of botanical medicine in the early nineteenth century to sophisticated cancer patient advocacy groups in the twenty-first. He vividly describes how activists and lawyers have resisted a wide variety of legal constraints on therapeutic choice, including medical licensing statutes, FDA limitations on unapproved drugs and alternative remedies, abortion restrictions, and prohibitions against medical marijuana and physician-assisted suicide. Grossman also considers the relationship between these campaigns for desired treatments and widespread opposition to state-compelled health measures such as vaccines and face masks. From the streets of San Francisco to the US Supreme Court, Choose Your Medicine examines an underexplored theme of American history, politics, and law that is more relevant today than ever.




Good Ethics and Bad Choices


Book Description

An analysis of how findings in behavioral economics challenge fundamental assumptions of medical ethics, integrating the latest research in both fields. Bioethicists have long argued for rational persuasion to help patients with medical decisions. But the findings of behavioral economics—popularized in Thaler and Sunstein’s Nudge and other books—show that arguments depending on rational thinking are unlikely to be successful and even that the idea of purely rational persuasion may be a fiction. In Good Ethics and Bad Choices, Jennifer Blumenthal-Barby examines how behavioral economics challenges some of the most fundamental tenets of medical ethics. She not only integrates the latest research from both fields but also provides examples of how physicians apply concepts of behavioral economics in practice. Blumenthal-Barby analyzes ethical issues raised by “nudging” patient decision making and argues that the practice can improve patient decisions, prevent harm, and perhaps enhance autonomy. She then offers a more detailed ethical analysis of further questions that arise, including whether nudging amounts to manipulation, to what extent and at what point these techniques should be used, when and how their use would be wrong, and whether transparency about their use is required. She provides a snapshot of nudging “in the weeds,” reporting on practices she observed in clinical settings including psychiatry, pediatric critical care, and oncology. Warning that there is no “single, simple account of the ethics of nudging,” Blumenthal-Barby offers a qualified defense, arguing that a nudge can be justified in part by the extent to which it makes patients better off.