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页数:288
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上传日期:2016-11-4 0:00:00

RISKY MEDICINE: OUR QUEST TO CURE FEAR AND UNCERTAINTY

Book ID/图书代码: 13560016B95912

English Summary/英文概要: Will ever-more sensitive screening tests for cancer lead to longer, better lives? Will anticipating and trying to prevent the future complications of chronic disease lead to better health? Not always, says Robert Aronowitz in Risky Medicine. In fact, it often is hurting us. Exploring the transformation of health care over the last several decades that has led doctors to become more attentive to treating risk than treating symptoms or curing disease, Aronowitz shows how many aspects of the health system and clinical practice are now aimed at risk reduction and risk control. He argues that this transformation has been driven in part by the pharmaceutical industry, which benefits by promoting its products to the larger percentage of the population at risk for a particular illness, rather than the smaller percentage who are actually affected by it. Meanwhile, for those suffering from chronic illness, the experience of risk and disease has been conflated by medical practitioners who focus on anticipatory treatment as much if not more than on relieving suffering caused by disease. Drawing on such controversial examples as HPV vaccines, cancer screening programs, and the cancer survivorship movement, Aronowitz argues that patients and their doctors have come to believe, perilously, that far too many medical interventions are worthwhile because they promise to control our fears and reduce uncertainty. Risky Medicine is a timely call for a skeptical response to medicine’s obsession with risk, as well as for higher standards of evidence for risk-reducing interventions and a rebalancing of health care to restore an emphasis on the actual curing of and caring for people suffering from disease.

Chinese Summary/中文概要: 更灵敏的癌症筛查试验是否会延长我们的生命?试图预防未来慢性病并发症会不会带给人们更好的健康?风险医学的Robert Aronowitz说,并不总是这样。事实上,这么做往往会伤害我们的健康。在过去几十年中,Aronowitz探索了医疗保健的转型,使医生更加地关注治疗风险,而不是治疗症状或治愈疾病。他展示了在卫生系统和临床实践中,有很多方面当下的目的是降低风险和控制风险。他认为这一转变部分是由制药行业推动的,制药行业通过将其产品推广到更大比例的有特定疾病风险的人群,而不是更小比例的实际受疾病影响的人群从而获益。同时对于慢性病患者来说,对他们疾病的治疗已经被那些注重预期治疗(如果不超过缓解疾病带来的痛苦)的医生们所忽视。Aronowitz引用了诸如人乳头瘤病毒疫苗、癌症筛查计划和癌症存活运动等具有争议性的例子来证明患者及其医生已经开始相信大多的医疗干预是值得的,因为他们可以减轻人们的恐惧并减少不确定性。《风险医学》是对医学对风险治疗的迷恋的及时回应,以及推动降低风险干预和重新平衡卫生保健,并恢复对实际治愈和护理病人的重视的最好证据。(YYW)

Awards/获奖情况:““降低疾病风险是如何逐渐成为现代医学信奉的真理的?”《风险医学》向人们讲述了一个重要的事实。它告诉我们在疾病和疾病的风险两者之间,我们已经分不清哪个才是我们现在在着重治疗的。作为一名医生和医学历史学家,Aronowitz用其不走寻常路的论据使读者感到震惊。而在他犀利敏锐的笔触中,他并没有过度简化对医生、研究人员、患者和政策制定者之间的辩论或侧写。他向我们展示了医学的风险革命为何如此重要,无论是对于那些必须在面对不确定性的情况下克服自身恐惧的个人,还是对于那些致力于在控制成本的同时改善大众健康状况的社会。”——Steven Epstein,《包容性:医学研究中的差异政治》的作者 “《风险医学》研究了风险和疾病在当代美国生物医学中倒塌的巨大影响。通过一系列历史和当代病例,临床医生/历史学家Aronowitz以高度的敏锐性解释了人们是如何走到这一步的:我们的医疗保健、健康政策和患者的经历中的许多是与其说是潜在的威胁,不如说是疾病本身造成的。这本非常敏锐大胆又人道的书从我们对疾病风险的关注入手,提供了对过度治疗的详细观察,以及新的层面上的体现和焦虑。”——Julie Livingston,《即兴医学:新兴癌症流行病中的非洲肿瘤病房》一书的作者

“在《风险医学》一书中,Aronowitz巧妙地分析了当代生物医学的本质。在我们降低疾病风险的努力中,我们不知不觉可能会加大这些风险。在我们努力减少对健康的不确定性的同时,我们又引入了新的不确定性。在一个以技术为核心的,监控测试治疗盛行的医学世界中,传统的“无害”医学信念几乎不可能实现。阅读过后,医生、历史学家、政策制定者和病人都将从这个强大的故事中获益。”——艾伦•M•布兰特,《烟草世纪》的作者

“这本书是对当代的管理和处理疾病的风格的一个重要又及时,带有挑衅意味的分析报告。在当今风险医学的世界中,我们逐渐开始诊断和治疗疾病的风险,如同我们治疗生理疼痛和生理能力丧失一样频繁,但我们却没有评估这种新型医疗制度的成本和效益。Aronowitz的有力分析表明了进行这种批判性评估的必要性;这本书应该得到广泛而热烈的评论。”——Charles E.Rosenberg,《我们如今的抱怨:美国医学》的作者

About the Author/作者介绍: Robert Aronowitz是宾夕法尼亚大学历史和科学社会学教授和主席,他在耶鲁大学获得医学学位。他的书包括《疾病的意义:科学、社会、疾病》和《乳腺癌和美国社会的非自然史》。他目前住在宾夕法尼亚州的梅里翁车站。

Robert Aronowitz is professor and chair of the history and sociology of science at the University of Pennsylvania; he earned his medical degree from Yale University. His books include Making Sense of Illness: Science, Society, and Disease and Unnatural History: Breast Cancer and American Society. He lives in Merion Station, Pennsylvania.

Format:HARDCOVER

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Complex/Traditional Chinese/繁体中文:AVAILABLE

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