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Medical Harm: Historical, Conceptual and Ethical Dimensions of Iatrogenic Illness, by Virginia Ashby Sharpe, Alan I. Faden
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It is estimated that up to thirteen percent of hospital admissions result from the adverse effects of diagnosis or treatment, and that anywhere from 44,000 to 98,000 hospital deaths annually are the result of errors. The obligation to "do no harm" has been central to medical conduct since ancient times, yet iatrogenic illness and medical error have now come to be recognized as significant risk factors in health care delivery. This book integrates history, philosophy, medical ethics and empirical data to examine the concept and phenomenon of medical harm. Issues covered include medical error, appropriateness of care, acceptable risk and practitioner accountability, and recommendations for limiting iatrogenic harm.
- Sales Rank: #2432053 in Books
- Brand: Brand: Cambridge University Press
- Published on: 1998-02-13
- Original language: English
- Number of items: 1
- Dimensions: 8.98" h x .63" w x 5.98" l, 1.05 pounds
- Binding: Paperback
- 296 pages
- Used Book in Good Condition
From The New England Journal of Medicine
The authors have chosen to use the term "medical harm" rather than "iatrogenic disease," principally because they are referring to incidents that occur during or as a result of treatment given not only by physicians but also by medical personnel of all types. They report that medical harm is experienced by almost 4 percent of hospitalized patients in the United States, a surprising and undoubtedly important number. In addition, they claim that more than two thirds of these harmful events are preventable. Given the scope of the problem, this book is an important one for medical professionals.
The book has three main parts. The first is a discussion of the authority of the medical profession as opposed to "the patient's rights." The second deals with the fine line between providing "due care" as a professional duty and simply "doing no harm." Appropriately, in the third part, the authors close the work with recommendations for limiting such harm.
The book is nicely written and makes for easy reading. Throughout, the authors use well-documented, specific cases to illustrate particular points. Some of these cases are well known, having been reported in newspapers nationwide -- for example, the case of the man in Florida, Willie King, who had gangrene of one leg and was mistakenly subjected to amputation of the other. Incidentally, the authors inadvertently include that story twice, once at the beginning of the book and again near the middle. However, that minor oversight does not detract at all from the value of the book as a whole.
The appendix comprises six excellent tables. The first, for example, provides the details of certain iatrogenic events that have occurred in hospital settings; the third is devoted to adverse effects of drugs in outpatients. There are numerous references at the end of every chapter, in addition to a 22-page bibliography with almost 500 references at the back of the book. The index is an asset, especially since it includes listings of the figures and tables.
Reviewed by Marie Valdes-Dapena, M.D.
Copyright © 1998 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.
Review
"Sharpe and Faden...have provided a useful exploration of the historical and ethical basis of medical harm laying the groundwork for addressing this problem." The Lancet
"As medicine gains new knowledge, its power for both harm and good expands exponentially. It becomes daily more urgent, therefore, for all of us to comprehend the ethical and scientific dimensions of medical harm. This book cogently and provocatively examines a neglected sector of modern medical practice." Edmund D. Pellegrino, M.D., Center for Clinical Bioethics, Georgetown University Medical Center
"In addition to providing a comprehensive distillation of the philosophical and ethical bases of medical practice as they relate to patient harm, several of the concepts advanced in this book are especially noteworthy." Journal of the American Medical Association
"Sharpe and Faden have written a thought-provoking and original book. Highly readable and impressive in scope, the work should engage a broad range of people interested in the health-care system, including but not limited to medical and nursing educators, health services researchers, bioethicists, and health-care policy analysts." Medical Humanities Review
"...provides an important history of the concept of iatrogenic illness, explores ethical tensions in the doctor-patient relationship, which make the recognition of error difficult, and provides valuable tools to resolve these tensions." Chicago Medicine
"...this book is an important one for medical professionals...nicely written and makes for easy reading. Throughout, the authors use well-documented, specific cases to illustrate particular points." New England Journal of Medicine
"This is a very important, groundbreaking overview of an issue about which there exists much intellectual and emotional confusion and misunderstanding in our culture with its excessive optimism about the beneficence of science and its medical applications." Doody's Health Sciences Book Review Journal
"Virginia Sharpe and Alan Faden have written a book that will be of great use to those trying to understand and minimize medical harm...I would encourage the medical ethics and education communities to consider Sharpe and Faden's framework for thinking about medical harm carefully as they develop and revise guidelines for professional practice." Feminist Approaches to Bioethics
About the Author
Faden is a Professor of Neurology and Pharmacology at the Georgetown Institute for Cognitive and Computational Sciences, Georgetown Medical Center.
Sharpe is a visiting scholar at the Center for Clinical Bioethics at Georgetown University.
Most helpful customer reviews
7 of 7 people found the following review helpful.
A timely read
By Writer
For anyone involved in the healing arts, the Institute of Medicine's (IOM) recent report on preventable errors could not have been a surprise. The book MEDICAL HARM...is an excellent and comprehensive look at the subject of iatrogenic illness and injury. It gives some valuable history that makes the IOM report more understandable. This book should be required reading for every health professional, medical and nursing student, hospital administrator and board member.
0 of 0 people found the following review helpful.
A brief critique of "Medical Harm"
By Philip Levitt
This is a highly academic exacting discussion of how and why doctors damage some of their patients and the view of the profession of this type of injury. It is very accurate and well researched. It tends toward the end of the spectrum which blames the systems in place in medicine as opposed to the individual responsibility of the doctor. It is an important part of the debate about how to make medicine safer.
0 of 0 people found the following review helpful.
Excellent read
By Amazon Customer
Dr. Faden's and Dr. Sharpe's book is exceptional and informational. I hope Dr. Faden will write a follow-up book in the near future.
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