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The Good Doctor: A Father, a Son, and the Evolution of Medical Ethics

de Barron H. Lerner

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559476,097 (4.23)14
The story of two doctors, a father and son, who practiced in very different times and the evolution of the ethics that profoundly influence health care As a practicing physicianand longtime member of his hospital's ethics committee, Dr. Barron Lerner thought he had heard it all.But in the mid-1990s, his father, an infectious diseases physician, told him a stunning story-he had physically placed his body over an end-stage patient who had stopped breathing,preventing his colleagues from performing cardiopulmonary resuscitation, even thoughCPR was the ethically and legally accepted thing to do. Over the next few years, the senior Dr. Lerner tried to speed the deaths of his seriously ill mother and mother-in-law to spare them further suffering. These stories angered and alarmed the younger Dr. Lerner-an internist, historian of medicine, and bioethicist-who had rejected physician-based paternalism in favor of informed consent and patient autonomy. The Good Doctoris a fascinating and moving account of how Dr. Lerner came to terms with two very different images of his father- a revered clinician, teacher, and researcher who always put his patients first, but also a physician willing to "play God," opposing the very revolution in patients' rights that his son was studying and teaching to his own medical students. But the elder Dr. Lerner's journals, which he had kept for decades, showed the son how the father's outdated paternalism had grown out of a fierce devotion to patient-centered medicine, which was rapidly disappearing. And they raised questions- Are paternalistic doctors just relics, or should their expertise be used to overrule patients and families that makeill-advised choices?Does the growing use of personalized medicine-in which specific interventions may be best for specific patients-change the calculus between autonomy and paternalism? And how can we best use technologies that were invented to save lives but now too often prolong death? In an era of high-technology medicine, spiraling costs, and health-care reform, these questions could not be more relevant. As his father slowly died of Parkinson's disease, Barron Lerner faced these questions both personally and professionally.He found himself being pulledinto his dad's medical care,even though he had criticized his father for making medical decisions for his relatives.Did playing God-at least in some situations-actually make sense? Did doctors sometimes "know best"? A timely and compelling story of one family's engagement with medicine over the last half century, The Good Doctoris an important book for those who treat illness-and those who struggle to overcome it.… (més)
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Ressenya escrita per a Crítics Matiners de LibraryThing .
I read this book because as a healthcare worker, I thought it would be interesting to see how ethics in healthcare has changed. This book definitely delivered. It was very thought provoking, and really makes a person realize the difficult decisions health care providers face when treating patients. Very well written. ( )
  ElianaFink | Mar 2, 2016 |
Ressenya escrita per a Crítics Matiners de LibraryThing .
What a story! Barron and Philip Lerner shared one major thing in common aside from the familial aspect. Barron and his father both became doctors. Largely because of age differences, the two approached their professional careers in quite different ways. Much changed from when the father became a physician until the son followed in his footsteps. The father is now gone and the biographical story written by his son is well worth reading.

The most obvious theme is how doctors approach ethics. Philip left a lasting mark by placing his own body between a terminally ill patient and other medical personnel so as to prevent the dying patient from being revived. He believed it best to allow the suffering to end when it reached the point of hopelessness. The father developed strong convictions about such things.

The son carefully observes differences between when his father was new to the medical profession and the present day. The gap in ethical practices is just part of it. The father's times now seem like ancient history. Like much of the rest of society, it was not uncommon for doctors to smoke. Doctors in the father's era of medicine were far less encumbered by the bureaucratic paperwork that has been forced upon the profession. It was common practice in times gone by to withhold from patients who were dying the fact that they were terminally ill.

The book is entitled The Good Doctor; A father, a Son, and the Evolution of Medical Ethics. It is quite thought provoking. I can see it sparking some interesting discussions in hospitals and doctor's offices. The lay person will like it too!
  JamesBanzer | Jul 2, 2015 |
Ressenya escrita per a Crítics Matiners de LibraryThing .
Though he would probably not agree -at least not in print - I felt that Barron Lerner very much wants to live in the world that his father lived in as a doctor and the haunting story that really controls this book is the reason why. As a senior physician and specialist his father literally came between his dead patient and a hospital code team and system that was determined to shred her last moment of dignity. This entire book, though filled with nuance and complex medical ethics (and quite well-written) never once convinced me that his father was anything but justified and even heroic in his actions. God I hope I don't die in a hospital. ( )
  michaelg16 | May 25, 2015 |
Ressenya escrita per a Crítics Matiners de LibraryThing .
Most of my research into health care is at the systems level, and so I found it deeply interesting to read this discussion of the personal and historical changes the author and his father experienced. I found the ethical discussions distracting in good ways, as they helped to ground the narrative and remind me of the importance of the decisions that the author and his fellow physicians made.

I don't entirely agree with some of the conclusions reached, but the love that Barron Lerner has for his profession, his patients, and his family is clear on every page. This book was full of the stories and questions that Lerner finds most important in his own life, and offered a very well-researched and direct portrait of Phillip Lerner, as well.

Ultimately, I found myself wondering if--despite his dedicated efforts and acknowledgement of the differences between them--Lerner was really ready to confront the disconnect between his own beliefs and those of the generation before. I'm not convinced that any child can be a parent's biographer--we all get caught up in memories of the people we wish to have raised us. But I applaud Lerner for the attempt, even as I'm left wondering it might have been better left to a grandchild, or someone with just slightly more distance from the enormous sea change that medicine has undergone in the past half-century.

Despite these reservations, or perhaps because of them, I found that Lerner did everything he could to incorporate his father's materials and his own dilemmas, and I'm glad that I read the book. I plan to share it with members of my family who are also in the field of health care, and hope that it becomes a work that is valued by the field for both the heartfelt memories it contains and the central questions it asks. ( )
  omphale23 | May 23, 2015 |
Ressenya escrita per a Crítics Matiners de LibraryThing .
I really liked this book and how Barron Lerner contrasted and compared the education and work lives between his father and himself . I liked how he explains how patient autonomy and bio ethics evolved. I am recommending book to my friends and look forward to having some great discussions. ( )
  marilynsantiago | May 19, 2015 |
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The story of two doctors, a father and son, who practiced in very different times and the evolution of the ethics that profoundly influence health care As a practicing physicianand longtime member of his hospital's ethics committee, Dr. Barron Lerner thought he had heard it all.But in the mid-1990s, his father, an infectious diseases physician, told him a stunning story-he had physically placed his body over an end-stage patient who had stopped breathing,preventing his colleagues from performing cardiopulmonary resuscitation, even thoughCPR was the ethically and legally accepted thing to do. Over the next few years, the senior Dr. Lerner tried to speed the deaths of his seriously ill mother and mother-in-law to spare them further suffering. These stories angered and alarmed the younger Dr. Lerner-an internist, historian of medicine, and bioethicist-who had rejected physician-based paternalism in favor of informed consent and patient autonomy. The Good Doctoris a fascinating and moving account of how Dr. Lerner came to terms with two very different images of his father- a revered clinician, teacher, and researcher who always put his patients first, but also a physician willing to "play God," opposing the very revolution in patients' rights that his son was studying and teaching to his own medical students. But the elder Dr. Lerner's journals, which he had kept for decades, showed the son how the father's outdated paternalism had grown out of a fierce devotion to patient-centered medicine, which was rapidly disappearing. And they raised questions- Are paternalistic doctors just relics, or should their expertise be used to overrule patients and families that makeill-advised choices?Does the growing use of personalized medicine-in which specific interventions may be best for specific patients-change the calculus between autonomy and paternalism? And how can we best use technologies that were invented to save lives but now too often prolong death? In an era of high-technology medicine, spiraling costs, and health-care reform, these questions could not be more relevant. As his father slowly died of Parkinson's disease, Barron Lerner faced these questions both personally and professionally.He found himself being pulledinto his dad's medical care,even though he had criticized his father for making medical decisions for his relatives.Did playing God-at least in some situations-actually make sense? Did doctors sometimes "know best"? A timely and compelling story of one family's engagement with medicine over the last half century, The Good Doctoris an important book for those who treat illness-and those who struggle to overcome it.

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