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Author: Bruce J. West Publisher: World Scientific ISBN: 9812568832 Category : Medical Languages : en Pages : 352
Book Description
Where Medicine Went Wrong explores how the idea of an average value has been misapplied to medical phenomena, distorted understanding and lead to flawed medical decisions. Through new insights into the science of complexity, traditional physiology is replaced with fractal physiology, in which variability is more indicative of health than is an average. The capricious nature of physiological systems is made conceptually manageable by smoothing over fluctuations and thinking in terms of averages. But these variations in such aspects as heart rate, breathing and walking are much more susceptible to the early influence of disease than are averages.It may be useful to quote from the late Stephen Jay Gould's book Full House on the errant nature of averages: ?? our culture encodes a strong bias either to neglect or ignore variation. We tend to focus instead on measures of central tendency, and as a result we make some terrible mistakes, often with considerable practical import.? Dr West has quantified this observation and make it useful for the diagnosis of disease.
Author: Bruce J. West Publisher: World Scientific ISBN: 9812568832 Category : Medical Languages : en Pages : 352
Book Description
Where Medicine Went Wrong explores how the idea of an average value has been misapplied to medical phenomena, distorted understanding and lead to flawed medical decisions. Through new insights into the science of complexity, traditional physiology is replaced with fractal physiology, in which variability is more indicative of health than is an average. The capricious nature of physiological systems is made conceptually manageable by smoothing over fluctuations and thinking in terms of averages. But these variations in such aspects as heart rate, breathing and walking are much more susceptible to the early influence of disease than are averages.It may be useful to quote from the late Stephen Jay Gould's book Full House on the errant nature of averages: ?? our culture encodes a strong bias either to neglect or ignore variation. We tend to focus instead on measures of central tendency, and as a result we make some terrible mistakes, often with considerable practical import.? Dr West has quantified this observation and make it useful for the diagnosis of disease.
Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309068371 Category : Medical Languages : en Pages : 312
Book Description
Experts estimate that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That's more than die from motor vehicle accidents, breast cancer, or AIDSâ€"three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems. To Err Is Human breaks the silence that has surrounded medical errors and their consequenceâ€"but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book sets forth a national agendaâ€"with state and local implicationsâ€"for reducing medical errors and improving patient safety through the design of a safer health system. This volume reveals the often startling statistics of medical error and the disparity between the incidence of error and public perception of it, given many patients' expectations that the medical profession always performs perfectly. A careful examination is made of how the surrounding forces of legislation, regulation, and market activity influence the quality of care provided by health care organizations and then looks at their handling of medical mistakes. Using a detailed case study, the book reviews the current understanding of why these mistakes happen. A key theme is that legitimate liability concerns discourage reporting of errorsâ€"which begs the question, "How can we learn from our mistakes?" Balancing regulatory versus market-based initiatives and public versus private efforts, the Institute of Medicine presents wide-ranging recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and development of effective systems at the level of direct patient care. To Err Is Human asserts that the problem is not bad people in health careâ€"it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocatesâ€"as well as patients themselves. First in a series of publications from the Quality of Health Care in America, a project initiated by the Institute of Medicine
Author: John A. Lynch Publisher: MSU Press ISBN: 1628953802 Category : Medical Languages : en Pages : 288
Book Description
The Origins of Bioethics argues that what we remember from the history of medicine and how we remember it are consequential for the identities of doctors, researchers, and patients in the present day. Remembering when medicine went wrong calls people to account for the injustices inflicted on vulnerable communities across the twentieth century in the name of medicine, but the very groups empowered to create memorials to these events often have a vested interest in minimizing their culpability for them. Sometimes these groups bury this past and forget events when medical research harmed those it was supposed to help. The call to bioethical memory then conflicts with a desire for “minimal remembrance” on the part of institutions and governments. The Origins of Bioethics charts this tension between bioethical memory and minimal remembrance across three cases—the Tuskegee Syphilis Study, the Willowbrook Hepatitis Study, and the Cincinnati Whole Body Radiation Study—that highlight the shift from robust bioethical memory to minimal remembrance to forgetting.
Author: Nicholas J. Gonzalez Publisher: ISBN: 9780982196533 Category : Cancer Languages : en Pages : 583
Book Description
In 1998, Nicholas Gonzalez, M.D. received National Cancer Institute approval for a clinical trial to evaluate his nutritional-enzyme approach in the treatment of patients with pancreatic cancer. Though Dr. Gonzalez hoped the venture would initiate an era of cooperation between conventional scientists and serious alternative researchers, problems plagued the study from its beginning. The design discouraged patient participation; conventional oncologists discouraged patients from joining and at times pressured those already admitted for nutritional therapy to change to more conventional treatment. Then in 2000 the NCI insisted that all patient selection decisions be turned over to the Principal Investigator, who as it turned out helped develop the chemotherapy protocol used as the control treatment.Repeatedly, the Principal Investigator approved patients for the nutritional treatment who did not meet the entry requirements, or who were too ill or uncommitted to follow the self-administered regimen. An evaluation by government scientists in early 2005 confirmed that so many patients had failed to follow the prescribed nutritional therapy that the data had little meaning. Despite such problems, without Dr. Gonzalez¿ knowledge the Principal Investigator published an article implying the study was properly run, patients complied fully and that the nutritional therapy had no effect.In response, Dr. Gonzalez, a former journalist, has written What Went Wrong, to bring the truth of this project to light, and show how bias, indifference, and at times incompetence undermined a promising research effort that, if properly run, might have ushered in a new direction in cancer treatment.
Author: Ben Goldacre Publisher: Macmillan ISBN: 0865478066 Category : Business & Economics Languages : en Pages : 479
Book Description
Argues that doctors are deliberately misinformed by profit-seeking pharmaceutical companies that casually withhold information about drug efficacy and side effects, explaining the process of pharmaceutical data manipulation and its global consequences. By the best-selling author of Bad Science.
Author: Paul A. Offit Publisher: HarperCollins ISBN: 0062947516 Category : Medical Languages : en Pages : 281
Book Description
An acclaimed medical expert and patient advocate offers an eye-opening look at many common and widely used medical interventions that have been shown to be far more harmful than helpful. Yet, surprisingly, despite clear evidence to the contrary, most doctors continue to recommend them. Modern medicine has significantly advanced in the last few decades as more informed practices, thorough research, and incredible breakthroughs have made it possible to successfully treat and even eradicate many serious ailments. Illnesses that once were a death sentence, such as HIV and certain forms of cancer, can now be managed, allowing those affected to live longer, healthier lives. Because of these advances, we now live 30 years longer than we did 100 years ago. But while we have learned much in the preceding decades that has changed our outlook and practices, we still rely on medical interventions that are vastly out of date and can adversely affect our health. We all know that finishing the course of antibiotics prevents the recurrence of illness, that sunscreens block harmful UV rays that cause skin cancer, and that all cancer-screening programs save lives. But do scientific studies really back this up? In this game-changing book, Dr. Paul A. Offit debunks fifteen common medical interventions that have long been considered gospel despite mounting evidence of their adverse effects, from vitamins, sunscreen, fever-reducing medicines, and eyedrops for pink eye to more serious procedures like heart stents and knee surgery. Analyzing how these practices came to be, the biology of what makes them so ineffective and harmful, and the medical culture that continues to promote them, Overkill informs patients to help them advocate for their health. By educating ourselves, we can ask better questions about some of the drugs and surgeries that are all too readily available—and all too heavily promoted.
Author: Simon LeVay Publisher: Penguin ISBN: 1440639388 Category : Science Languages : en Pages : 308
Book Description
Brilliant scientific successes have helped shape our world, and are always celebrated. However, for every victory, there are no doubt numerous little-known blunders. Neuroscientist Simon LeVay brings together a collection of fascinating, yet shocking, stories of failure from recent scientific history in When Science Goes Wrong. From the fields of forensics and microbiology to nuclear physics and meteorology, in When Science Goes Wrong LeVay shares twelve true essays illustrating a variety of ways in which the scientific process can go awry. Failures, disasters and other negative outcomes of science can result not only from bad luck, but from causes including failure to follow appropriate procedures and heed warnings, ethical breaches, quick pressure to obtain results, and even fraud. Often, as LeVay notes, the greatest opportunity for notable mishaps occurs when science serves human ends. LeVay shares these examples: To counteract the onslaught of Parkinson’s disease, a patient undergoes cutting-edge brain surgery using fetal transplants, and is later found to have hair and cartilage growing inside his brain. In 1999, NASA’s Mars Climate Orbiter spacecraft is lost due to an error in calculation, only months after the agency adopts a policy of “Faster, Better, Cheaper.” Britain’s Bracknell weather forecasting team predicts two possible outcomes for a potentially violent system, but is pressured into releasing a ‘milder’ forecast. The BBC’s top weatherman reports there is “no hurricane”, while later the storm hits, devastating southeast England. Ignoring signals of an imminent eruption, scientists decide to lead a party to hike into the crater of a dormant volcano in Columbia, causing injury and death. When Science Goes Wrong provides a compelling glimpse into human ambition in scientific pursuit.
Author: Danielle Ofri, MD Publisher: Beacon Press ISBN: 0807037885 Category : Medical Languages : en Pages : 274
Book Description
Medical mistakes are more pervasive than we think. How can we improve outcomes? An acclaimed MD’s rich stories and research explore patient safety. Patients enter the medical system with faith that they will receive the best care possible, so when things go wrong, it’s a profound and painful breach. Medical science has made enormous strides in decreasing mortality and suffering, but there’s no doubt that treatment can also cause harm, a significant portion of which is preventable. In When We Do Harm, practicing physician and acclaimed author Danielle Ofri places the issues of medical error and patient safety front and center in our national healthcare conversation. Drawing on current research, professional experience, and extensive interviews with nurses, physicians, administrators, researchers, patients, and families, Dr. Ofri explores the diagnostic, systemic, and cognitive causes of medical error. She advocates for strategic use of concrete safety interventions such as checklists and improvements to the electronic medical record, but focuses on the full-scale cultural and cognitive shifts required to make a meaningful dent in medical error. Woven throughout the book are the powerfully human stories that Dr. Ofri is renowned for. The errors she dissects range from the hardly noticeable missteps to the harrowing medical cataclysms. While our healthcare system is—and always will be—imperfect, Dr. Ofri argues that it is possible to minimize preventable harms, and that this should be the galvanizing issue of current medical discourse.
Author: Lucian L. Leape Publisher: Springer Nature ISBN: 3030711234 Category : Medical Languages : en Pages : 450
Book Description
This unique and engaging open access title provides a compelling and ground-breaking account of the patient safety movement in the United States, told from the perspective of one of its most prominent leaders, and arguably the movement’s founder, Lucian L. Leape, MD. Covering the growth of the field from the late 1980s to 2015, Dr. Leape details the developments, actors, organizations, research, and policy-making activities that marked the evolution and major advances of patient safety in this time span. In addition, and perhaps most importantly, this book not only comprehensively details how and why human and systems errors too often occur in the process of providing health care, it also promotes an in-depth understanding of the principles and practices of patient safety, including how they were influenced by today’s modern safety sciences and systems theory and design. Indeed, the book emphasizes how the growing awareness of systems-design thinking and the self-education and commitment to improving patient safety, by not only Dr. Leape but a wide range of other clinicians and health executives from both the private and public sectors, all converged to drive forward the patient safety movement in the US. Making Healthcare Safe is divided into four parts: I. In the Beginning describes the research and theory that defined patient safety and the early initiatives to enhance it. II. Institutional Responses tells the stories of the efforts of the major organizations that began to apply the new concepts and make patient safety a reality. Most of these stories have not been previously told, so this account becomes their histories as well. III. Getting to Work provides in-depth analyses of four key issues that cut across disciplinary lines impacting patient safety which required special attention. IV. Creating a Culture of Safety looks to the future, marshalling the best thinking about what it will take to achieve the safe care we all deserve. Captivatingly written with an “insider’s” tone and a major contribution to the clinical literature, this title will be of immense value to health care professionals, to students in a range of academic disciplines, to medical trainees, to health administrators, to policymakers and even to lay readers with an interest in patient safety and in the critical quest to create safe care.
Author: Bruce J. West
Author: Bruce J. West
Author: Institute of Medicine
Author: John A. Lynch
Author: Nicholas J. Gonzalez
Author: Ben Goldacre
Author: Paul A. Offit
Author: Simon LeVay
Author: Danielle Ofri, MD
Author: Trevor A. Kletz
Author: Lucian L. Leape