Hippocratic Oaths - Medicine and its Discontents by Raymond Tallis. Hard Bound, 6" x 9.5".
Atlantic Books, (an imprint of Grove Atlantic Ltd.), Ormond House, 26-27 Boswell Street, London WC1N 3JZ, Tel: (44)-(0)20 7269 1610, Fax: (44)-(0)20 7430 0916, E-mail: firstname.lastname@example.org. Publication Date 12 August 2004. x + 342 pages, ISBN 1-84354-126-2. Price £19.99
The National Health Service of Great Britain (NHS) was once a model of medical excellence, and for some it still is. In recent times though there has been a series of so-called scandals involving the health service and there is considerable dissatisfaction with the service.
What happened in the last few years? Has the health service truly deteriorated or is it just that the expectation of the general public has changed? The talk now is of doom and gloom and the extraordinary advances in medicine in the last few decades have all but been forgotten. What seems to matter is the latest "health scare" or the latest health "scandal"!
Hippocratic Oaths by Raymond Tallis tackles the problem head on.
This is no ordinary book written in haste by an author with knowledge gained entirely from press cuttings. Hippocratic Oaths is Raymond Tallis's personal view and is a collection of a lifetime's thought and medical practice by an eminent British medical practitioner who philosophises about health, our bodies, the way we perceive our bodies and the state of the health service. The author is well qualified to discuss the current state of the National Health Service. Apart from being a practising physician he is also the Chairman of the Committee on Ethical Issues in Medicine of the Royal College of Physicians. The result is a brilliant analysis of modern medicine and the NHS.
Where others in the profession have adopted a fatalistic attitude and have resigned themselves to the "inevitability" of the future Tallis prefers to raise his head above the parapet. Tallis speaks for most of us, if not all of us, in the health service.
As the reader is informed in the introduction, this book is a triptych: the larger middle section deals with present discontents. It is flanked by panels that deal, respectively, with the origins and the destination of the art of medicine.
The first part therefore takes the reader through the history of health care. The middle part covers the present discontents and the so-called scandals. The third part looks into the future.
Medicine is still a young science and Tallis mentions the fact that scientific astronomy antedated scientific cardiology by thousands of years. Indeed modern scientific therapeutics is less than a hundred years old. The work of Vesalius (1543) and William Harvey (1628) are considered landmarks in the development of scientific medicine. Both authors of course described how the body looked when exposed to the unprejudiced eye, what its structure was and how it might function. Scientific medicine of course had to advance against the opposition from theological and other convictions. The struggle is not yet over. The opposition now comes in the form of media frenzy.
Understandably the main focus of the book is on Contemporary Discontents and in particular there is a good discourse on the so-called Organ Retention Scandal, but other present day discontents, such as the controversy surrounding the MMR vaccine, are also discussed in an extremely readable and succinct fashion. It is probably in the third section (Destinations) that Tallis comes into his own.
Will the medical profession continue to be a profession or will it be reduced to another service industry? As patients become clients or customers will the doctor become a vendor rather than a professional? Will doctors raised in a consumerist society end up as consumers too? Since very few people have all the skills increasingly being demanded from doctors would future physicians become ever more accomplished actors? Will Evidence-Based Medicine give way to Lawyer-Proof Medicine or Grievance-Resistant Medicine? Will the doctors of the future do the unpaid work that earlier generations accepted as the norm? Will an aggressively consumerist society breed defensive consumerist physicians? What will be the effect of the notion of 'life-work balance' on the profession?
All good thought provoking stuff!
This is a well-researched book and not the mere ravings of a disgruntled member of the profession. The extensive reference notes at the end of the book vouch for that. There is no doubt it will become a keystone in the future thinking of the medical profession.
Tallis is a master of the written word and the book is written in an extremely readable style.
Using thought provoking headings such as 'The End of Medicine as a Profession?' and 'Everyone Has To Die Sometime' Tallis holds the attention of the reader throughout.
As far as printing goes this is a quality hardback book, well printed and well bound.
This is a timely book when morale in the medical profession is at an all-time low. I found it fascinating reading. It is essential reading for all members of the medical profession as well as those in the Government who hold the reins of the Health Service of Britain.
Gyan Fernando is a West Country Forensic Pathologist. He has spent half his life in Sri Lanka, a developing country with poor medical care, and (nearly) the other half in Britain, a developed country with excellent medical care....or is it the otherway round?.
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