I am a recently retired general surgeon [40 years] and live inbeautiful colorado springs, colorado.
" Better" is a nonfiction book written by Atul Gawande, a general surgion. He interviews several pnysicians working in different fields of medicine in various parts of the world. His interviews range from following an infectious disease team in a large hospital who are developing methods to decrease the incidence of hospital transferred infections. Their major work is in creating ways that will improve hospital staff activities such as hand washing and the use of sterile techniques to eleminate Staph infections in catheters and IV lines.
His next interview involves a public health team in remote villages in India who are trying to eradicate polio through vaccinations. This team has to overcome the local superstitions but is able to vaccinate over 4 million children and to almost stamp out polio in that region.
He then interviews a few physicians and one nurse who have attended executions in our penal system even thought the AMA has an ethics clause opposing physician attendance at executions. Some states require a physician attendance at executions which adds to the moral dilemma.
He describes three essentials for a physician to have to be successful in medicne. The first is diligence which requires giving sufficient detail to avoid errors and prevail against obstacles. The second is ingenuity which demands a willingness to recognize failure and thus accept change. The third is the challenge to do right and overcome human failings.
He concludes his book discussing the choices that a doctor has to make always in the best interest of his patient. The doctor patient relationship is a very private one and the information that the doctor receives should be taken with great confidence. The choices that the doctor makes on behalf of his patient may alter his patient's life and thus should be made with great care. If the choice was of no benefit to the patient, then the doctor should be intropespective enough to accept the failure and look for a change in direction.
This nonfiction review provides a compelling discussion of the moral responsibilities of the doctor and should be on every permedical and medial student's reading list.
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