Eric J. Cassell Clinical Professor of Public Health Cornell University Medical College's Books

The Nature of Suffering and the Goals of Medicine

By: Eric J. Cassell Clinical Professor of Public Health Cornell University Medical College

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The Nature of Suffering and the Goals of Medicine

By: Eric J. Cassell Clinical Professor of Public Health Cornell University Medical College

The Nature of Suffering underscores the change that is taking place in medicine from a basic concern with disease to a greater focus on the sick person. Cassell centers his discussion on the problem of suffering because, he says, its recognition and relief are a test of the adequacy of any system of medicine. He describes what suffering is and its relationship to the sick person: bodies do not suffer, people do. An exclusive concern with scientific knowledge of the body and disease, therefore, impedes an understanding of suffering and diminishes the care of the suffering patient. The growing criticism that medicine is not sufficiently humanistic does not go deep enough to provide a basis for a new understanding of medicine. New concepts in medicine must have their basis in its history and in the development of ideas about disease and treatment. Cassell uses many stories about patients to demonstrate that, despite the current dominance of science and technology, there can be no diagnosis, search for the cause of the patient's disease, prognostication, or treatment without consideration of the individual sick person. Recent trends in medicine and society, Cassell believes, show that it is time for the sick person to be not merely an important concern for physicians but the central focus of medicine. He addresses the exciting problems involved in such a shift. In this new medicine, doctors would have to know the person as well as they know the disease. What are persons, however, and how are doctors to comprehend them? The kinds of knowledge involved are varied, including values and aesthetics as well as science. In the process of knowing the experience of patient and doctor move to center stage. He believes that the exploration of the person will engage medicine in the 21st century just as understanding the body has occupied the last hundred years.

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277

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Oxford University Press, USA

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ISBN 10

0198021941

ISBN 13

9780198021940

The Nature of Suffering and the Goals of Medicine

By: Eric J. Cassell

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The Nature of Suffering and the Goals of Medicine

By: Eric J. Cassell

This is a revised and expanded edtion of a classic in palliative medicine, originally published in 1991. With three added chapters and a new preface summarizing our progress in the area of pain management, this is a must-hve for those in palliative medicine and hospice care. The obligation of physicians to relieve human suffering stretches back into antiquity. But what exactly, is suffering? One patient with metastic cancer of the stomach, from which he knew he would shortly die, said he was not suffering. Another, someone who had been operated on for a mior problem--in little pain and not seemingly distressed--said that even coming into the hospital had been a source of pain and not suffering. With such varied responses to the problem of suffering, inevitable questions arise. Is it the doctor's responsibility to treat the disease or the patient? And what is the relationship between suffering and the goals of medicine? According to Dr. Eric Cassell, these are crucial questions, but unfortunately, have remained only queries void of adequate solutions. It is time for the sick person, Cassell believes, to be not merely an important concern for physicians but the central focus of medicine. With this in mind, Cassell argues for an understanding of what changes should be made in order to successfully treat the sick while alleviating suffering, and how to actually go about making these changes with the methods and training techniques firmly rooted in the doctor's relationship with the patient. Dr. Cassell offers an incisive critique of the approach of modern medicine. Drawing on a number of evocative patient narratives, he writes that the goal of medicine must be to treat an individual's suffering, and not just the disease. In addition, Cassell's thoughtful and incisive argument will appeal to psychologists and psychiatrists interested in the nature of pain and suffering.

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336

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Oxford University Press

Published Date

ISBN 10

0199748004

ISBN 13

9780199748006

Doctoring

The Nature of Primary Care Medicine

By: Eric J. Cassell M.D.

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Doctoring

The Nature of Primary Care Medicine

By: Eric J. Cassell M.D.

American medicine attracts some of the brightest and most motivated people the country has to offer, and it boasts the most advanced medical technology in the world, a wondrous parade of machines and techniques such as PET scans, MRI, angioplasty, endoscopy, bypasses, organ transplants, and much more besides. And yet, writes Dr. Eric Cassell, what started out early in the century as the exciting conquest of disease, has evolved into an overly expensive, over technologized, uncaring medicine, poorly suited to the health care needs of a society marked by an aging population and a predominance of chronic diseases. In Doctoring: The Nature of Primary Care Medicine, Dr. Cassell shows convincingly how much better fitted advanced concepts of primary care medicine are to America's health care needs. He offers valuable insights into how primary care physicians can be better trained to meet the needs of their patients, both well and sick, and to keep these patients as the focus of their practice. Modern medical training arose at a time when medical science was in ascendancy, Cassell notes. Thus the ideals of science--objectivity, rationality--became the ideals of medicine, and disease--the target of most medical research--became the logical focus of medical practice. When clinicians treat a patient with pneumonia, they are apt to be thinking about pneumonia in general--which is how they learn about the disease--rather than this person's pneumonia. This objective, rational approach has its value, but when it dominates a physician's approach to medicine, it can create problems. For instance, treating chronic disease--such as rheumatoid arthritis, diabetes, stroke, emphysema, and congestive heart failure--is not simply a matter of medical knowledge, for it demands a great deal of effort by the patients themselves: they have to keep their doctor appointments, take their medication, do their exercises, stop smoking. The patient thus has a profound effect on the course of the disease, and so for a physician to succeed, he or she must also be familiar with the patient's motivations, values, concerns, and relationship with the doctor. Many doctors eventually figure out how to put the patient at the center of their practice, but they should learn to do this at the training level, not haphazardly over time. To that end, the training of primary care physicians must recognize a distinction between doctoring itself and the medical science on which it is based, and should try to produce doctors who rely on both their scientific and subjective assessments of their patients' overall needs. There must be a return to careful observational and physical examination skills and finely tuned history taking and communication skills. Cassell also advocates the need to teach the behavior of both sick and well persons, evaluation of data from clinical epidemiology, decision making skills, and preventive medicine, as well as actively teaching how to make technology the servant rather than the master, and offers practical tips for instruction both in the classroom and in practice. Most important, Doctoring argues convincingly that primary care medicine should become a central focus of America's health care system, not merely a cost-saving measure as envisioned by managed care organizations. Indeed, Cassell shows that the primary care physician can fulfill a unique role in the medical community, and a vital role in society in general. He shows that primary care medicine is not a retreat from scientific medicine, but the natural next step for medicine to take in the coming century.

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224

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Oxford University Press

Published Date

ISBN 10

0190289236

ISBN 13

9780190289232

The Nature of Clinical Medicine

The Return of the Clinician

By: Eric J. Cassell

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The Nature of Clinical Medicine

The Return of the Clinician

By: Eric J. Cassell

The Nature of Clinical Medicine takes its direction from a catalog of goals of medicine that range from the expected diagnosis and treatment of diseases to wider concerns for patients, for physicians, and for medicine itself. Eric Cassell is specific in teaching the kinds of knowledge that clinicians require in order to be able to achieve these goals.

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353

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Oxford University Press, USA

Published Date

ISBN 10

0199974861

ISBN 13

9780199974863

The Nature of Healing

The Modern Practice of Medicine

By: Eric J. Cassell

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The Nature of Healing

The Modern Practice of Medicine

By: Eric J. Cassell

In this book, Eric Cassell explores what sickness is, what persons are, and how to understand function and its impairments. He explains healing skills and actions, as well as the nature of healing for sick and suffering patients. This book concludes with a discussion of the moral basis of the relationship between patient and healer. explores what sickness is, what persons are, and how to understand function and its impairments. He explains healing skills and actions, as well as the nature of healing for sick and suffering patients. This book concludes with a discussion of the moral basis of the relationship between patient and healer, as well as the goals of healing.

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320

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OUP USA

Published Date

ISBN 10

019536905X

ISBN 13

9780195369052

Doctoring

The Nature of Primary Care Medicine

By: Eric J. Cassell M.D.

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Doctoring

The Nature of Primary Care Medicine

By: Eric J. Cassell M.D.

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221

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Oxford University Press

Published Date

ISBN 10

019802729X

ISBN 13

9780198027294

The Healer's Art

By: Eric J. Cassell

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The Healer's Art

By: Eric J. Cassell

Beyond drugs, beyond technology, there will always be the human element, the healer's art. Dr. Cassell discusses the world of the sick, the healing connection and healer's battle, the role of omnipotence in the healer's art, illness and disease, and overcoming the fear of death. Eric J. Cassell, M.D., is an internist and clinical director of the Program for the Study of Ethics and Values in Medicine at Cornell Medical School. His two-volume work Talking with Patients: The Theory of Doctor-Patient Communication, and Clinical Technique, is available from The MIT Press in cloth and paperback.

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244

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MIT Press

Published Date

ISBN 10

0262530627

ISBN 13

9780262530620

Book's by Eric J. Cassell Clinical Professor of Public Health Cornell University Medical College

The Nature of Suffering and the Goals of Medicine

The Nature of Suffering and the Goals of Medicine

The Nature of Suffering and the Goals of Medicine

The Nature of Suffering and the Goals of Medicine

Doctoring

Doctoring

The Nature of Clinical Medicine

The Nature of Clinical Medicine

The Nature of Healing

The Nature of Healing

Doctoring

Doctoring

The Healer's Art

The Healer's Art

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