Strong Medicine: The Ethical Rationing of Health Care - Tapa dura

"I consider Menzel's discussion to be one of the most creative, imaginative, original pieces of philosophy I have seen. He knows the economic and medical literature, gets to the critical issues in fresh and exiting ways, and invariably upsets conventional wisdom in a carefully reasoned manner." --Robert M. Veatch, Georgetown University "Menzel's book is a major contribution to one of the most theoretically complex and practically urgent problems of our time: how can we ration health care ethically? Strong Medicine is accessible to a broad audience, yet analytically incisive and morally sensible." --Allen Buchanan, Professor of Philosophy, University of Arizona "This is an important and challenging work. Highly recommended for upper division and graduate collections." --Choice "Strong Medicine is a challenging and controversial book . . . . This is an important and timely book on a pressing issue in health policy. [This book] should be read by everyone concerned about the ethical implications of health-care rationing. Throughout the book Menzel displays a sophisticated understanding of economics, rigor in argumentation, and the courage to take positions that are certain to be unpopular . . . . Menzel has taken a straightforward and appealing value and has worked out its implications across a wide range of very difficult problems. Health care professionals, ethicists, and economics will learn a great deal from Strong Medicine. It deserves to be read and debated." --Bioethics Books "A stimulating and provocative volume, clearly written, well reasoned, and a definite contribution to the moral literature on justice and health-care rationing." --Medical Humanities Review "A good book, strong on the application of the theory to rationing problems in health care. . . .Essential reading to those interested both in the practice of health care, and more broadly, that of applied ethics as a whole." --Bioethics "[Menzel's] approach is critical and interesting." --Doctor-Patient Studies

In one form or another, health care is now being rationed; not every patient receives all that is possibly beneficial for him - sometimes with tragic consequences. Decisions to ration raise a classic dilemma: how can we treat an individual with dignity and genuine respect when he is being short-changed by an efficient policy that seems best overall?

Strong Medicine argues that we can respect the individual, if those policies represent the hard trade-off preferences of patients controlling resources for their larger lives. Rationing is still strong medicine to swallow, but then it becomes what patients, as well as the doctor, ordered. Menzel develops this central idea and applies it to major issues of health policy and economics: the notion of pricing life, the long-run cost of prevention, measuring quality of life, imperilled newborns, adequate care for the poor, containing costs by market competition, malpractice suits, procuring organs for transplant, and dying expensively in old age. He provides a hard-hitting, critical philosophical discussion of these issues, in non-technical language accessible to a wide range of readers.