This ground-breaking book by one of the nation's leading experts on medical ethics, Daniel Callahan, traces the root cause of America's health-care crisis not to inefficient organization or waste, but rather to society's and the medical community's relentless quest for perfection.
In recent decades, we have seen five perilous and interlocking trends dominate global discourse: irreversible climate change, extreme food and water shortages, rising chronic illnesses, and rampant obesity. Why can't we make any progress in counteracting these problems, despite vast expenditures of intellectual, institutional, and societal capital? What makes these global emergencies the "wicked problems" that resist our best efforts and only grow more daunting?Daniel Callahan, noted author and the nation's preeminent scholar in bioethics, takes a cross-cutting look at these global problems and shines a light on the institutions, practices, and actors that block major change. We see partisan political and ideological forces, old fashioned hucksters, and trumped up scientific disagreements, but also the problem of modern progress itself. Obesity, anthropocentric climate change, wasting illnesses, ecological degradation, and global famine are often the unintended consequences of unchecked industrial growth, reckless eating habits, and artificially extended lifespans. Only through well-crafted political, regulatory, industrial, and cultural counterstrategies can we change enough minds to check these threats. Big thinking on issues that are usually evaluated separately, this book is sure to scramble partisan divides and provoke unusual, heated debate.
Daniel Callahan helped invent the field of bioethics more than forty years ago when he decided to use his training in philosophy to grapple with ethical problems in biology and medicine. Disenchanted with academic philosophy because of its analytical bent and distance from the concerns of real life, Callahan found the ethical issues raised by the rapid medical advances of the 1960s--which included the birth control pill, heart transplants, and new capacities to keep very sick people alive--to be philosophical questions with immediate real-world relevance. In this memoir, Callahan describes his part in the founding of bioethics and traces his thinking on critical issues including embryonic stem cell research, market-driven health care, and medical rationing. He identifies the major challenges facing bioethics today and ruminates on its future. Callahan writes about founding the Hastings Center--the first bioethics research institution--with the author and psychiatrist Willard Gaylin in 1969, and recounts the challenges of running a think tank while keeping up a prolific flow of influential books and articles. Editor of the famous liberal Catholic magazine Commonweal in the 1960s, Callahan describes his now-secular approach to issues of illness and mortality. He questions the idea of endless medical "progress" and interventionist end-of-life care that seems to blur the boundary between living and dying. It is the role of bioethics, he argues, to be a loyal dissenter in the onward march of medical progress. The most important challenge for bioethics now is to help rethink the very goals of medicine.
Technological innovation is deeply woven into the fabric of American culture, and is no less a basic feature of American health care. Medical technology saves lives and relieves suffering, and is enormously popular with the public, profitable for doctors, and a source of great wealth for industry. Yet its costs are rising at a dangerously unsustainable rate. The control of technology costs poses a terrible ethical and policy dilemma. How can we deny people what they may need to live and flourish? Yet is it not also harmful to let rising costs strangle our health care system, eventually harming everyone? In Taming the Beloved Beast, esteemed medical ethicist Daniel Callahan confronts this dilemma head-on. He argues that we can't escape it by organizational changes alone. Nothing less than a fundamental transformation of our thinking about health care is needed to achieve lasting and economically sustainable reform. The technology bubble, he contends, is beginning to burst. Callahan weighs the ethical arguments for and against limiting the use of medical technologies, and he argues that reining in health care costs requires us to change entrenched values about progress and technological innovation. Taming the Beloved Beast shows that the cost crisis is as great as that of the uninsured. Only a government-regulated universal health care system can offer the hope of managing technology and making it affordable for all.
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