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The purpose of this book is to examine the opportunities for, and limitations to, empowerment among adults with severe mental illness who, historically, have lacked power and have been the focus of stigma and discrimination. Its central premise is that despite significant limitations to empowerment, people with severe mental illness can be empowered when certain conditions are met. Building on the work of Joel F. Handler, nine conditions are outlined under which empowerment is likely to occur and be sustained long-term. These conditions are then applied to determine the circumstances under which people with severe mental illness can be empowered through participation in each of seven activities. These including treatment planning; the selection and control of housing; decision making in the organizations from which services are received; planning and policy making; securing and maintaining employment that produces a liveable wage; research and evaluation; and service provision to other people with mental illness. Case studies from a public psychiatric hospital and a community mental health agency illustrate each of the seven areas. Finally, the book identifies the roles that service providers, administrators, policy makers, advocacy groups, researchers, and clients can play in the empowerment process.

Most chronically and terminally ill patients are cared for in their own homes by family and friends, rather than in hospitals or hospices. These carers are an invaluable free resource and there is an increasing amount of research into their role and the experiences of caring for the terminally ill, patients with cancer, and patients with other chronic diseases. This book provides a critique of the theoretical concept of caring, carers, and caregivers. The material is based on empirical evidence from recent studies of adults with acquired chronic illnesses, including terminal illness. The empirical data within the book has been gathered from the perspective of those providing personal, domestic, or emotional care to others already known to them by virtue of kinship, co-habitation, or friendship, rather than carers organised on a professional or voluntary basis. This new evidence is used to make suggestions about possible ways forward within health and social care practice.

Antibiotics will soon no longer be able to cure common illnesses such as strep throat, sinusitis, and middle ear infections as they have done previously. Antibiotic-resistant bacteria are increasing at a much faster rate than new antibiotics to treat them are being developed. The prescription of antibiotics for viral illnesses is a key cause of increasing bacterial resistance. Despite this fact, many children continue to receive antibiotics unnecessarily for the treatment of viral upper respiratory tract infections. Why do American physicians continue to prescribe inappropriately given the high social stakes of this action? The answer appears to lie in the fundamentally social nature of medical practice: physicians do not prescribe as the result of a clinical algorithm but prescribe in the context of a conversation with a parent and a child. Thus, physicians have a classic social dilemma which pits individual parents and children against a greater social good. This book examines parent-physician conversations in detail, showing how parents put pressure on doctors in largely covert ways. It also shows how physicians yield to this seemingly subtle pressure evidencing that apparently small differences in wording have important consequences for diagnosis and treatment recommendations. Following parents use of these interactional practices, physicians are more likely to make concessions, alter their diagnosis or alter their treatment recommendation. This book also shows how small changes in the way physicians present their findings and recommendations can decrease parent pressure for antibiotics. It carefully documents the important and observable link between micro social interaction and macro public health domains.

This book provides a unique view of patients, families, and their caregivers striving together to maintain comfort and hope in the face of incurable illness. The narratives weave together emotions, physical symptoms, spiritual concerns, and the stresses of family life, as well as the professional and personal challenges of providing hospice and palliative care. Based on a vast amount of participant observation and in-depth interviews, the book moves far beyond dry technical manuals for symptom control and tired clichés about death with dignity, to depict the sights, sounds, tastes, and smells of the daily in patients' homes and the palliative care unit. It captures the breathtaking diversity of people's aspirations and ideals as they face death, and the views of the professionals who care for them. Anger and fear, tenderness and reconciliation, jealousy and love, social support and falling through the cracks, unexpected courage and unshakable faith—all of these are part of facing death in late twentieth-century North America, and this book brings them to life in a portrait of the processes of giving and receiving palliative care.

Drawing from his extensive clinical experience and many years of teaching, the author of this book has written a guide to palliative care for clinicians. The topics addressed range from an overview of death and dying to specific approaches to symptom management. As an introduction to both the art and science of palliative care, the book reflects the perspectives of one physician who has dedicated his career to this rapidly evolving field. It links real stories of illness with practical advice, thereby delineating clinical practice in a way that reflects the daily concerns of clinicians.

This collection of essays is united by a common concern with basic questions pertaining to law and morality and the relation between the two. The first essay considers whether judges must appeal to natural law or natural justice when the law seems incomplete or indeterminate. In cases in which the law is immoral, natural law theorists and legal positivists align in their rejection of a moral obligation to obey the law. The second essay defends the view that moral rights exist independently of institutional structures. The complex issue of criminal entrapment is the focus of the third paper, and the position defended is that although an entrapped person sometimes may not be held criminally liable for the crime she voluntarily commits as a result of police enticement, in many cases we may make adverse moral judgments about her conduct. The view espoused in the fourth essay is that completed crimes and failed attempts should be treated in the same way when determining the appropriate punishment. The fifth essay offers various arguments to support the claim that funding of the arts through taxation is justified. Among other things, the arts offer intrinsic, though often benefitless, value to society, which is worthwhile to maintain and preserve. In the sixth paper, the discussion focuses on the notion of pure evil, or sheer wickedness, contrasting it with that of mental illness (or sick! sick! sickness) and identifying some places in which this distinction blurs. The final essay in this collection looks at how, since Plato's time, moral language and psychiatric language have fused ideas of immorality and mental illness.

Most people with far-advanced illness wish to be cared for at home for as long as possible. The challenge of providing good palliative care at home is therefore of major importance for family doctors, nurses, and all those committed to maintaining the highest possible quality of life for the dying person. As modern specialist palliative care has raised both standards of care and also public expectations of family doctors and community nurses, this book helps to place specialist care in context. As palliative care is a major responsibility for teams providing care at home, the book provides a definitive guide on how to provide effective care for people with far-advanced disease. It has been written by two palliative specialists, both of whom have been family doctors. The book deals with all the physical, emotional, spiritual, and social problems that will be encountered by family doctors and community nurses caring for patients and relatives in a home setting. It deals in detail with emergencies, communications, and ethical issues, and emphasises throughout the importance of team work.

Illness narratives have become a cultural phenomenon in the Western world but their analysis continues to be framed by the context of biomedicine, the doctor-patient encounter and the demands of medical training. This reductive attitude prevents the inclusion of more formally experimental genres, different themes and interdisciplinary methods within the field. It also perpetuates the view of the medical humanities as a narrow area of study largely serving the needs of medicine. Exploring the aesthetic, ethical and cultural importance of contemporary representations of illness across different arts and media, this book intervenes in current debates in medical humanities/medical education by emphasising more critical as opposed to instrumental approaches. Opening up the category of illness narrative to consider forms beyond literature, Illness as Many Narratives includes chapters on photography, artists’ books, performance art, film, theatre, animation and online narratives. The book examines different physical and mental illness experiences in both autobiographical and collaborative/relational narratives and offers new close readings of diverse works by Jo Spence, Sam Taylor-Wood, Martha A. Hall, Guillermo Gómez-Peña, Wim Wenders, Lisa Kron and others. Approaching illness and its treatments as a multiplicity and situating them in relation to aesthetics, theory, radical pedagogy, politics and contemporary cultural concerns, Illness as Many Narratives demonstrates how bringing in diverse materials and engaging with multiple perspectives can help the arts, cultural studies and the medical humanities to establish critical conversations and amplify the goals and scope of their respective work.

This book details the various ways in which epidemiologic methods can improve food safety. Starting with a history and background of food-borne illness, the book continues by describing the means of investigating an outbreak and measuring exposure, and concludes by looking at the regulatory context in the United States.

Stories of illness and healing are often arresting in their power, illuminating practices and experiences that might otherwise remain obscure. What can be learned through a comparative look at the range of narrative theories and styles of narrative analysis used by anthropologists to make sense of their ethnographic data? Do divergent strategies yield different understandings of the illness experience and healing practices? Does a focus on narrative detract from or conceal other, more fruitful avenues for exploration? Through the analysis of stories drawn from a variety of ethnographic contexts, the contributors to this book address such questions. The book unites medical anthropology and narrative analysis to illuminate how personal narrative shapes the architecture of illness and the life course it yields.