What do you do with a book that in spite of disagree with the vantage point of the author, you have to admit that the points he raises and the stand he takes has some validity? That an author can cause the reader to stop and think about firmly held belief systems, is indicative of a good writer in my opinion.

The author of this bioethical treatise is not a physician. He is a sociologist, and he is giving the historical background to the immense changes in how the American public views its medical establishment. In the process of becoming involved in ethics in the medical world, Rothman had to come in close contact with those he was writing about...physicians. I get the feeling that he was and to a point still in awe of the great men and the great minds he has been exposed to. Occasionally, the book seemed to be biased in favor of the physicians. A book such as this cannot be written without showing the author's own biases; author's can only admit that they harbor particular biases towards those they are writing about.

In many issues Rothman comes down solidly on behalf of the physicians, whether or not they brought about the changes in the public's attitudes towards those who work in medicine. Rothman bemoans the fact that the public has involved lawyers, bioethicists, and politicians in what used to be the private domain of physicians. Yet he writes and explains the history behind this lowering of pedestals for doctors and medical researchers...all the while trying to explain why physicians felt their patients should rely 'on those who know and understand' (read that to mean physicians think most patients and families are too stupid to understand basic concepts).

This book actually gives a good and vitally important background into the movements for individual rights and the exposure of unethical experimentation and medical treatment which led to the creation of new standards for medical care and research, as well as the installment of Internal Research Boards (IRBs) which are suppose to act as brakes on over-ambitious and unethical practices. Unfortunately, it is all too clear in recent media reports that even IRBs in universities and hospitals are not enough to protect the American public from research by those not interested in protecting the patients and alleviating pain, but rather shows more concern for keeping the grant money coming, fame, and doing science merely for the sake of doing science ('because we can!) John Hopkins obviously hasn't changed its attitudes over 30 some odd years towards the rights of the individual, since they are continuing to attract attention and controversy because of unethical research.

This book is definitely a must-read for anyone interested in bioethics. Even if the reader does not agree with the author, the book provides a different, and somewhat valid reflection of the medical establishment's views towards the infringement of their previously existing rights in determining patient care and the moral standards of research. Karen Sadler, Science Education, University of Pittsburgh

This book makes a real contribution to the understanding of bioethics in the US, explaining how we got from the paternalistic consciousness in health care that allowed pre-WW II human experimentation on vulnerable subjects such as the one at Tuskegee, to the present day's ethics committees with its emphasis on patient autonomy. I would recommend it to anyone interested in bioethics.

Rothman gives his readers the gift of ingenuity: "a spineso huge, a spine so straight!" and a book so fresh that I'vealready read through it several times. Each line surprises yet reminds; each poem is a careful patience. An excellent read!

This poetry anthology by 12 Colorado writers is a real keeper. The backgrounds of the poets are as diverse as their poetry. Whatever your taste in poetry you are sure to find something that speaks to you. Humor, regret, nature, politicss, love, and a dash of magic are all represented in light and darkness. The diversity of the poetry is amazing considering the writers all reside on the common ground of the Western Slope of Colorado. Wallace Stegner, dean of writers of the West, wrote that "...no place is a place until it has had a poet..." If that is true, the Western Slope of Colorado is truly a place thanks to these poets. This collection, now in it's second edition, is a must have for anyone remotely interested in contemporary poetry of the first rank.

I was surprised to be the first to offer a user review of this book; it was really fascinating. Rothman provides a short, "page-turner", essay-style book looking at landmark decision points in the development of modern U.S. healthcare, from the invention of the iron lung and renal dialysis (rationing problems), to the political battles between socioeconomic classes, AMA, and unions in the development of Medicare and Blue Cross. As I write this, Amazon features a long review from the New England Journal of Medicine which is favorable about this readable and challenging book, but notes the reader may debate Rothman's conclusions as well as agree with them. It's a great overview of modern US healthcare which may leave the reader with more memorable "take home lessons" than the 500-page histories of healthcare and society. Rothman's approach may shape the way you think about other aspects of American culture and history as well !