First, Do No Harm: The Dramatic Story of Real Doctors and Patients Making Impossible Choices at a Big-City Hospital

Sure there is plenty of powerful content to praise, but first I want to celebrate author Lisa Belkin's fabulous writing style. She sure knows how to tell a gripping and compelling story. In the tradition of nonfiction writers who write like novelists such as Jon Krakauer (Into Thin Air) and Mark Bowden (Black Hawk Down) Belkin fuses top-notch reporting with authentic protagonist voices, brilliant insights, and the ability to surface root causes, map out trends, and distill the core philosophical issues at stake.Belkin applies these gifts to telling the story of the most wrenching life and death ethical dilemmas staff, doctors, nurses, and family members face at Hermann Hospital in Houston, Texas. Amazing advances in medical technology have forced all of us to confront questions never before encountered: when do we stop trying to keep someone alive? what is the definition of quality of life? who gets to decide -- the doctors or the family members? what is the difference between the law, ethics, and morals? how to best live with the decision once it's made?It takes courage to delve into these questions and to bear the responsibility for them as the ethics committee does at Hermann. It also took a great amount of bravery to offer journalist Belkin unrestricted access to the inner workings of the hospital and the committee. The result is a significantly important book that contributes in vital ways to the ongoing conversations we need to be having in society and among our families as technology puts us more in the position of having to make god-like decisions.

I am a big fan of medical books, with all their stories about doctors and patients. My shelves are replete with them, including books by Frank Huyler and Jerome Groopman, Jerald Winakur and Atul Gawande, just to name a few. I love stories that humanize hospitals and their staff, and make us empathize and educate us on what goes on inside those walls.This book gets an A+ in that regard. Lisa Belkin divides her book up by months, and within those months we revisit certain patients to see their progress. We come to know and care about all of them - from the tiniest of premature babies, to those with devastating injuries and illnesses that foretell the bleakest of futures.But this book is more than just our empathizing with these patients and learning about their treatments, it's also about finding out how the medical staff deals with all this on a regular basis. It's not only the patients we come to know and care about in this book.In addition, there are fascinating chapters that take us inside the ethics committees that determine the future course of action for these patients, and let us know how the doctors determine when to proceed with procedures that may or may not help, and when the very real problems of hospital finances becomes intertwined with these complicated decisions.I read this book in one sitting and it both moved me and educated me. Highly recommended.

I read this a few years back. It was thought provoking enough to purchase in hardcover and keep on my shelf.

I could hardly put this book down until I was finished with it. It was not just eye-opening about how some of the ethical choices in medicine must be made, including the all-too necessary financial considerations. It showed how human doctors are and how difficult it can be for them to have to make heart-wrenching decisions in which there is no right answer, especially when it is clear that, no matter which choice they make, there is not going to be a good outcome for the patient. In spite of their training and attempt to insulate themselves emotionally from their cases in order to remain objective and professional, it's not always possible. Ms. Belkin's descriptions of doctors in tears was very moving, and proved to me that those people chose the right profession, because they really do care about their patients.I found, by searching for them on the AMA web site, that a lot of the doctors in this book are still in practice in Houston (one is in Albuquerque). This search gave absolute credence to the fact that these stories are not fiction but about real people.

First, Do No Harm . Here we are, in August 2009, with a very heated battle going on in regards to the health insurance battle. People are worried about death panels, Nazi health care (we will be treating Nazis?), and a number of hysterical assumptions. Guess what! Death panels have existed under other names, or perhaps no names at all. Some hospitals call them Ethics Committees, when they are named. But if you are ever involved with the long-term care of someone who is critically ill, a birth defect, or a severe car accident, YOU become part of a death panel, like it or not. Through describing the life & death situations of a variety of patients, author Lisa Belkin educates us in an area a lot of what we don't want to admit to: we will all die, and someone other than ourselves could be making that decision as to when.

I highly recommend this book. It is a difficult book to put down. Written with amazing and factual insight into the decisions made every day at hospitals. It is an intellectual must read for people who believe there are "cut and dried" answers for patients. Lisa skillfully cut from one patient to the next, keeping you on the edge of your seat as she masterfully tells the story of each patient for whom ethical decisions had to be made. It may be eyeopening for some people to realize that when you or your loved one is hospitalized, all bets are off as to life and death decisions. You may find yourself at the mercy of the hospital ethics commitee. Welcome to the world of modern medical science.

Interesting.

大変内容が重い書である。不治の重症患者の治療を継続するか打ち切るすなわち積極的に安楽死させるべきか、医師、家族、患者本人、ケースワーカーー、関連ナース達の心の葛藤をきめ細かく描写している。そして、病院倫理委員会での議論の様子が如実に示されている。わが国では積極的安楽死は現在は認められていないが、医療費高騰と高齢患者の増加からと個人の尊厳の点から、近い将来に積極的安楽死が認められることが予測されるから、本書は貴重な参考書と思われる。それに医療費未払いの施療患者に対しても差別することなく、標準的な医療を継続させるハーマン病院の理念には敬服させられる。なお、筆者は女性ジャーナリストで医療者ではないのに、実に細かく病院や医学的描写をしており、感心させられ、秀逸な書である。書名は、医聖ヒポクラテスが医師としての心構えとして述べた「まず何よりも患者に害を与えてはならない」という意味で、現代においても研修医教育の原点として普及している言葉である。

Haven't read it yet but am told it is an humbling and uplifting read