Already the recipient of extraordinary critical acclaim, this magisterial book provides a landmark account of American medical education in the twentieth century, concluding with a call for the reformation of a system currently handicapped by managed care and by narrow, self-centered professional interests. Kenneth M. Ludmerer describes the evolution of American medical education from 1910, when a muck-raking report on medical diploma mills spurred the reform and expansion of medical schools, to the current era of managed care, when commercial interests once more have come to the fore, compromising the training of the nation's future doctors. Ludmerer portrays the experience of learning medicine from the perspective of students, house officers, faculty, administrators, and patients, and he traces the immense impact on academic medical centers of outside factors such as World War II, the National Institutes of Health, private medical insurance, and Medicare and Medicaid. Most notably, the book explores the very real threats to medical education in the current environment of managed care, viewing these developments not as a catastrophe but as a challenge to make many long overdue changes in medical education and medical practice. Panoramic in scope, meticulously researched, brilliantly argued, and engagingly written, Time to Heal is both a stunning work of scholarship and a courageous critique of modern medical education. The definitive book on the subject, it provides an indispensable framework for making informed choices about the future of medical education and health care in America.

This text aims to provide a framework within which informed choices can be made regarding the future of medical education and health care in America.

Already the recipient of extraordinary critical acclaim, this magisterial book provides a landmark account of American medical education in the twentieth century, concluding with a call for the reformation of a system currently handicapped by managed care and by narrow, self-centered professional interests.Kenneth M. Ludmerer describes the evolution of American medical education from 1910, when a muck-raking report on medical diploma mills spurred the reform and expansion of medical schools, to the current era of managed care, when commercial interests once more have come to the fore, compromising the training of the nation's future doctors. Ludmerer portrays the experience of learning medicine from the perspective of students, house officers, faculty, administrators, and patients, and he traces the immense impact on academic medical centers of outside factors such as World War II, the National Institutes of Health, private medical insurance, and Medicare and Medicaid. Most notably, the book explores the very real threats to medical education in the current environment of managed care, viewing these developments not as a catastrophe but as a challenge to make many long overdue changes in medical education and medical practice.Panoramic in scope, meticulously researched, brilliantly argued, and engagingly written, Time to Heal is both a stunning work of scholarship and a courageous critique of modern medical education. The definitive book on the subject, it provides an indispensable framework for making informed choices about the future of medical education and health care in America.

Human genetic engineering may soon be possible. The gathering debate about this prospect already threatens to become mired in irresolvable disagreement. After surveying the scientific and technological developments that have brought us to this pass, The Ethics of Genetic Engineering focuses on the ethical and policy debate, noting the deep divide that separates proponents and opponents. The book locates the source of this divide in differing framing assumptions: reductionist pluralist on one side, holist communitarian on the other. The book argues that we must bridge this divide, drawing on the resources from both encampments, if we are to understand and cope with the distinctive problems posed by genetic engineering. These problems, termed "fractious problems," are novel, complex, ethically fraught, unavoidably of public concern, and unavoidably divisive. Berry examines three prominent ethical and political theories – utilitarianism, Kantianism, and virtue ethics – to consider their competency in bridging the divide and addressing these fractious problems. The book concludes that virtue ethics can best guide parental decision making and that a new policymaking approach sketched here, a "navigational approach," can best guide policymaking. These approaches enable us to gain a rich understanding of the problems posed and to craft resolutions adequate to their challenges.

Visual texts uniquely demonstrate the contested terms of American identity. In American Archives Shawn Michelle Smith offers a bold and disturbing account of how photography and the sciences of biological racialism joined forces in the nineteenth century to offer an idea of what Americans look like--or "should" look like. Her varied sources, which include the middle-class portrait, baby picture, criminal mugshot, and eugenicist record, as well as literary, scientific, and popular texts, enable her to demonstrate how new visual paradigms posed bodily appearance as an index to interior "essence." Ultimately we see how competing preoccupations over gender, class, race, and American identity were played out in the making of a wide range of popular and institutional photographs. Smith demonstrates that as the body was variously mapped and defined as the key to essentialized identities, the image of the white middle-class woman was often held up as the most complete American ideal. She begins by studying gendered images of middle-class domesticity to expose a transformation of feminine architectures of interiority into the "essences" of "blood," "character," and "race." She reads visual documents, as well as literary texts by Nathaniel Hawthorne, Pauline Hopkins, and Theodore Dreiser, as both indices of and forms of resistance to dominant images of gender, class, race, and national identity. Through this analysis Smith shows how the white male gaze that sought to define and constrain white women and people of color was contested and transformed over the course of the nineteenth century. Smith identifies nineteenth-century visual paradigms that continue to shape debates about the terms of American belonging today. American Archives contributes significantly to the growing field of American visual cultural studies, and it is unprecedented in explaining how practices of racialized looking and the parameters of "American looks" were established in the first place.